Leader Information

Please choose which church youth group your student is associated with

Emergency Contact Information

Please list any allergies, prescription medications taken daily, medical limitations that would prevent student from participating in camp activities (NOTE: All prescription medications will be turned into a nurse on site and will be distributed based on the dosage instructions on the package) IF NONE PLEASE TYPE N/A
Does nursing staff have permission to administer over the counter medications in the appropriate dosage if needed (including but not limited to: Aspirin, Tylenol, Cough Syrup, Lozenges, Antacid, Sunscreen, Pepto-Bismol, etc.)

Additional Medical Information