Camper Medication Form

Camper Name(*)

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Please explain the need for medication (*)

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Please list all medications required and the dosage for each(*)

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Medication Expiration

I have verified that all medication is current and not expired. Invalid Input

Permission

I give permission for the Camp Nurse or Director to administer medications listed above to my child. Invalid Input

Prescription medication must be in original container with Camper’s name and dosage clearly indicated. Over the counter non-prescription medication must be labeled with Camper’s name. All medication must be CURRENT. ALL medications, prescription or non-prescription, must be submitted with this accompanying document, to be distributed as needed by the Camp Director. This applies to Campers, Volunteers and Leaders. ***There should be NO MEDICATION in cabins or backpacks.***

Captcha(*)

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Medications Form