Camper Health & Emergency Information
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Full name of person filling out this form *
Relationship to camper *
Email address for person filling out this form *
Parent/guardian phone number *
Please choose a secret code word or phrase for camper pickups. Anyone picking up a camper will be required to provide this code. *
Which camp weeks are you attending? *
Camper full name *
Camper birthdate *
MM
/
DD
/
YYYY
Camper preferred pronouns *
Emergency contact name *
Emergency contact phone number *
Camper health information
Please include any allergies, medications, or other health information that our staff should be aware of.
We like to offer Otter Pops as an afternoon treat when a group is working together to have a great day at camp. Is this treat ok for your camper? *
Please pack a different sweet treat if your camper is unable to eat Otter Pops
Anything else you'd like to tell us about how we can support your camper?
Hold Harmless Agreement *
I agree to hold harmless Meter Music School for any costs or liabilities which may be incurred as a result of my child's participation in camp activities.
Required
Medical Release *
In case of emergency, I hereby authorize Meter Music School staff to secure medical treatment for my child.
Required
Media Release *
I understand that some photos and videos will be taken during camp, and that the school policy is to identify students by first name only if photos or videos are used in promotional or educational materials.
Required
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