Summer Camp Health Form 2026

Camper Physical Documentation

All campers are required to submit a copy of their latest health physical (the form generally provided to schools or, the "blue form"). The date of exam on the physical submitted must have been within 36 months (3 years) from the FIRST day the camper is at camp.
Attached is a copy if a new form is needed. Please print and have your camper's physician fill out. (Right click to give print options)
Upload completed physical form here!*

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Medications
All medications brought to camp by campers, including vitamins and over the counter medications, must be brought in their original container, and accompanied by a physician's order (also called authorization to administer medication form). This form must come from the physician's office and be signed by the physician. Check below if your camper will have medication at camp.*

My camper will have medication at campMy camper will NOT have medication at camp
If your child WILL have medication, please upload the completed form(s) here!*

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Permission to carry Asthma Inhalers and Emergency Auto-Injectors Self administrations of medication may be authorized by the prescriber and parent/guardian for inhalers for asthma and cartridge injectors for medically-diagnosed allergies at summer camp. This requires the written authorization of an authorized prescriber and written authorization from the camper parent/guardian. To obtain the form required, contact customer care, and indicate below.*

My camper will need to carry an inhaler for asthma and/or emergency auto-injector at camp.My camper will NOT need to carry an inhaler for asthma and/or emergency auto-injector at camp.
If your child WILL carry an epi-pen or inhaler, we require a Plan of Care from their physician. Please upload a copy that form(s) here.*

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Girl Scout Permission and Activity Waiver

Girl Scouts of Connecticut camps and outdoor program centers frequently have rustic and uneven terrain that may include hills, woodlands, and waterfront areas whose navigation may require concentrated physical exertion (such as walking, hiking, or swimming). Many of the programs/activities described in camp or program literature and provided by Girl Scouts of Connecticut include a variety of physical activities in the outdoors. By signing this consent for your Girl Scout to participate, you acknowledge that their participation in the program activities, as described in the camp brochure and other materials, requires an acceptance of possible serious injury to your camper. You have made your own judgement that your camperis capable of participating in activities at camp. You also are representing to Girl Scouts of Connecticut that your camper has no undisclosed condition that might affect their fitness or ability to participate with or without reasonable accommodation.

In any program/activity at summer camp, there is always some risk of personal injury or property damage. In return for the agreement to permit your camper to participate, you agree that you will not sue Girl Scouts of Connecticut, (hereafter the “council”) and its members, employees, agents, assigns or volunteers for any injury to your camper that results from or may aggravate the inherent risks of your camper’s participation in a program/activity at summer camp. The inherent risks involved in participation in any program/activity include those injuries which result from circumstances or actions of persons who are not employees or agents of the council.

Please read this agreement carefully and make certain that you understand it fully before signing it. By signing below, you may be giving up substantial rights that belong to you and your Girl Scout camper. You agree that you are signing this consent freely and voluntarily. My camper is in good health and can fully participate in all general activities.
Signature of Camper Parent/Guardian for Girl Scout Permission and Activity Waiver: *

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Signature and Authorization for Medical Treatment

I hereby authorize the Girl Scouts of Connecticut (GSOFCT) and any medical personnel selected by the camp to provide medical assessment and routine medical treatment and services to my camper, including hospitalization, and necessary related transportation, and in case of an emergency, authorize the provision of medically necessary treatment/services, including transfer to a hospital or facility for emergency treatment/services. I release GSOFCT and its officers, directors, employees, personnel from and against any and all claims and liability arising from or related to the provision, authorization and administration of medical treatment, services and medication to my camper.
Signature of Camper Parent/Guardian for Authorization for Medical Treatment: *

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Girl Scouts of CT Summer Camp Health Form 2026

Parent/Guardian and Emergency Contact Information

Camper Information

Camper Code of Conduct

Camper Health History and Insurance

Camper Medical History

Allergies

Health Exam and Immunization Information

Camper Physical Documentation

Medications