Clone of Individual Medication Card 2025

King Solomon Christian Camp

Individual Medication Card 2026
We require separate information for each different medication your child/student will be bringing with them to camp. All medications, whether prescription or over-the-counter, need to be sent to camp in their ORIGINAL packaging.
Camper's Name:
Camp Attending:
In total, how many different medications will be sent with your camper? (including both prescriptions & over-the-counter medications)
Medication 1
Medication 1 Name:
Reason Medication 1 is prescribed/used:
Dosage (Med 1):
To be administered at what times? (choose all that apply) (Med 1)

Other
Does your child have any additional medications for which you need to provide information?

Medication 2
Medication 2 Name:
Reason Medication 2 is prescribed/used:
Dosage (Med 2):
To be administered at what times? (choose all that apply) (Med 2)

Other
2.) Does your child have any additional medications for which you need to provide information?

Medication 3
Medication 3 Name:
Reason Medication 3 is prescribed/used:
Dosage (Med 3):
To be administered at what times? (choose all that apply) (Med 3)

Other
3.) Does your child have any additional medications for which you need to provide information?

Medication 4
Medication 4 Name:
Reason Medication 4 is prescribed/used:
Dosage (Med 4):
To be administered at what times? (choose all that apply) (Med 4)

Other
4.) Does your child have any additional medications for which you need to provide information?

Medication 5
Medication 5 Name:
Reason Medication 5 is prescribed/used:
Dosage (Med 5):
To be administered at what times? (choose all that apply) (Med 5)

Other
5.) Does your child have any additional medications for which you need to provide information?

Medication 6
Medication 6 Name:
Reason Medication 6 is prescribed/used:
Dosage (Med 6):
To be administered at what times? (choose all that apply) (Med 6)

Other
If your child has more than 6 medications, please sign and submit this form with its current information, then go back to the form at https://form.jotform.com/kingsolomoncamp/IMC26 to complete the additional medication information. Thank you!

Medication 1