Kids & Student Camp Medical Form

Kids & Student Camp Medical Form
While at Summer Camp, the Kids & Student Medical Teams work to treat the medical needs of each participant as they arise. Each kid/student attending will be required to have this brief medical form completed, as it provides helpful information to our team. Please provide accurate information below. If you have more than one kid/student attending, please complete a separate form for each person.
Participant's Name:

First NameLast Name
Participant's Grade (completed Summer 2026):
Parent's Name:

First NameLast Name
Parent's Cell Phone Number:
Please enter a valid phone number.Format: (000) 000-0000.
Parent's Email:
example@example.com
Please list any significant medical conditions that our medical team needs to be aware of.
Please list any allergies with specific reactions that our medical team needs to be aware of.
I, PARENT'S NAME HERE*, understand that Kids/Student Camp Medical Team will provide over-the-counter medications on an as needed basis for the treatment of various symptoms that students could develop throughout the week. Examples of such symptoms include, but are not limited to: headache/general pain, nausea, diarrhea, upset stomach, rash, bug bites/stings, itching/hives, cold symtpoms, sunburn, and toothaches.
Please select the following:
** If you selected WITH SOME RESTRICTIONS, please list those restrictions here.
Signature
Should be Empty: