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Be sure to fill out both the health AND emergency forms -- provided below.
Please complete online, print, sign and return by mail (signature required in two places).
Name of camper: Date of Birth:
Blood Pressure: Weight: Height:
DATE OF LAT FULL PHYSICAL
Medical History (for positive findings)
IMMUNIZATIONS TO DATE (Exact dates, please, not "up-to-date" or "current")
Date of MMR 2nd dose (Boys entering 6th grade or above should have 2nd MMR)
Date of last Tetanus Date of last TB test Pos. Neg.
Your signature below authorizes the camp nurse to dispense the following over-the-counter medications:
Signature: ____________________________ Date: ______________
If your son is to receive prescription medications, uses an inhaler, or needs an Epipen, please enclose a written order from your physician and send the medications in the original pharmacy-labeled container. No prescription medications will be dispensed unless they are in a pharmacy-labeled container.