Camper Children Registration Form

Camper Children Registration Form

Are you planning to make a camping event for children? Used this Registration Form Template so their parent can easily register their kids for the upcoming camp event and include their kid's Camper's emotional/behavioral History. Form Preview
2016 Child's Application
  • Camper Registration Form

  • Sponsoring Church Name: _________________

    Camp Dates: _________________

  • Instructions:  This form must be completely filled out. The information is vital to the health and well being of the child. Your application will not be valid if it is not filled out completely.

    Submission of this application does not guarentee your child's reservation for camp.  You will be notified of your confirmed camp reservation by the local camp director/placement coordinator.

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  • Campers Emotional/Behavioral History

  • Camper Details

  • Health History

  • Indicate all known allergies, illness, disabilities, physical limitations or medical complications:

  • Immunization History

  • Please fill in dates  of basic immunizations and most recent booster as best as you can 

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  • Perscription Medications: all medications sent to camp must be in origional container with pharmacy labels on it.

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  • Please add any other comments related to HEALTH and MEDICATIONS on an additional sheet 

  • I understand that it is my responsibility as caregiver to make sure that all instructions are clear and that the necessary dosage is adequately supplied for the duration of camp.  I hereby authorize RFK’s Camp nurse to administer the above medication from

                                                              

  • Medical Release Form:

  • This health history is correct so far as I know, and the above named minor has permission to engage in all prescribed program activities, except as noted.  The undersigned do hereby authorize the directors of Royal Family KIDS Camp, or such substitute as they may designate, as agent for the undersigned to consent to an X-Ray examination, anesthetic, medical, dental or surgical diagnosis or treatment and hospital care for the above minor which is deemed advisable by and to be rendered under the general or special supervision of any physician and surgeon, licensed under the provision of the Medicine Practice Act or any dentist licensed under the Dental Practice Act, whether such diagnosis or treatment is rendered at the office of said physician or dentist, at a hospital, camp or elsewhere.  This authorization will remain effective while the above minor is enroute to and from or involved or participating in any camp program, unless revoked in writing by the undersigned and delivered to the Director of Royal Family as legal guardian/social worker/other.  I give my permission for Child's Name:__________________________________ to attend Royal Family KIDS Camp in the summer of ___________ through Sponsoring Church's Name:__________________________                                                      

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  • PERMISSION TO ADMINISTER OVER-THE-COUNTER MEDICATIONS

     

    I hereby give the Royal Family KIDS’ Camp Registered Nurse permission to administer the following products according to manufacturer’s instructions, or as otherwise specified.

     

    I trust the RFK Camp Registered Nurse to use her best judgment as situations arise, and if in doubt, he/she can call for verification.

     

  • Please check YES or NO for the medications listed blow.  This form must be completely filled out by the primary caregiver who signs below, or camper may not attend camp.

  • Clear
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  • PLEASE NO CAMERAS OR MONEY AS

    THESE ITEMS ARE NOT NEEDED AT CAMP.

     

  • Should be Empty: