CELP Allergy/Food Intolerance Form
PLEASE ONLY FILL OUT THIS FORM IF YOU OR YOUR CHILD HAS AN ALLERGY OR FOOD INTOLERANCE AND WILL REQUIRE SPECIAL ACCOMMODATIONS AT CAMP. ALL PARTICIPANTS ARE REQUIRED TO FILL OUT SEPARATE CELP HEALTH FORM PROVIDED BY YOUR SCHOOL.
Name of School
CELP Participant Information
A CELP participant is any student, teacher or parent attending CELP.
Name of CELP Participant with allergy or food intolerance:
This person is a:
Chaperone (all adults attending CELP are considered chaperones)
Please provide DETAILED information below to ensure a healthy camp experience.
Please list participant's allergies or food intolerances:
What is the reaction to the allergen or food?
If exposed to the allergen or food, what treatment should be provided?
What medication(s) will be brought on the trip?
Are there any special instructions on use or storage or medications?
Will special meal arrangements be required?
If yes, please describe in detail.
Name and Contact Info of Person Completing this Form
This form completed by:
Please provide name below:
Relation to participant:
Example: parent, guardian, health professional, etc.
If we have further questions, how can we contact you?
Please provide phone and/or email address below:
Thank you for providing the information above. You will be contacted by CELP if there are any questions or if further coordination is required. If you would like to contact us directly, please email CELP wellness coordinator Holly Kern at
A copy of your responses will be emailed to the address you provided.
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This form was created inside of Catalina Island Camps.
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