Junior Week 2026
  • Junior Week

    Please fill out 1 form per camper. Thank you!
  • Camper's Date of Birth*
     - -
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Liability & Off Camp Release PDF

    Camp Policy Letter PDF

  • After reading both documents above,*
  • Permission to Use Video/Photos*
  • Insurance & Health

    All campers are responsible for their own medical coverage.
  • Medical Clearance Form PDF

  • Health History - Camper has the following (if any)
  • Date of last tetanus shot*
     - -
  • Medications

    Please list all medications (Prescription/Over-the-Counter/Vitamins/Herbs) below. ALL medications must be in the ORIGINAL CONTAINER and will be left with and dispensed by the Health Supervisor. Prescribed medicines must be kept in the original packaging/bottle that identifies the prescribing physician (if prescription), name of medicine, dosage & frequency.

    We understand that medications may change and this form may be updated at check-in if necessary.

  • HEALTH CENTER MEDICATIONS

    These medications are stocked at Camp Epachiseca. Please indicate your permission to administer these over-the-counter medications, or if you wish to be notified first. (Some meds are listed as common brand names, though generic may be substituted.)

  • I give my permission for the camp to administer the over-the-counter medications that I check WITHOUT NOTIFYING ME FIRST.
  • I give my permission for the camp to administer the over-the-counter medications that I check BUT CALL ME FIRST.
  • Ability to swim*
  • Camper Release/End of Camp:

  • As the custodial parent/guardian of the camper named above, I give my permission to Camp Epachiseca to release my child for pick up from Camp Epachiseca to the following person(s):*
  • Billing

  • I will pay Debit or Credit*

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      Junior Early Bird

      Grades 3-5 July 12-18

      $230.00$230.00
        

      Debit or Credit Card
    • By entering your name below, you are electronically signing this form and verifying that:

      1. All information is accurate to the best of your knowledge.

      2. I have read and will honor the cell phone and electronic devices policy.

    • Date of Electronic Signatures*
       - -
    • Should be Empty: