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Summer Camps 2019: General Information and Medical Form

March Break & Summer Camps 2019: General Information and Medical Form

Dear Parent/Guardian,

Please complete and submit this form by the first day of camp.

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General Information
CHILD'S INFORMATION
PARENT/GUARDIAN CONTACT INFORMATION
#1
#2
PICK-UP LIST / ALTERNATIVE EMERGENCY CONTACT
#1
#2
Only the people listed on your pick-up information on the above list, and those listed under Parent/Guardian, will be permitted to pick your child up from camp. Any changes to this information must be submitted in writing to the program leader. Photo identification may be required.
PARENT/GUARDIAN CONSENT TO SIGN IN/OUT
I GIVE PERMISSION FOR MY CHILD TO SIGN IN ALONE AT THE SCHEDULED TIME.

I GIVE PERMISSION FOR MY CHILD TO SIGN OUT ALONE AT THE SCHEDULED TIME.

The camp day ends at 4:00pm. If your child has enrolled in Extended Care, please pick them up by 6:00pm. Please acknowledge by providing your signature below:
Medical Information
*Please note that RCM is NOT a nut-free facility.
DOES YOUR CHILD REQUIRE MEDICATION TO BE ADMINISTERED WHILE THEY ARE AT THE PROGRAM?

DOES YOUR CHILD REQUIRE AN EPIPEN?

If you answered "Yes" to either of the above medical questions, please speak with the program leader when you hand in this form.
MEDICAL RESTRICTION(S) ACKNOWLEDGEMENT