Camper Medication Information
Please fill out the required fields regarding your camper's medications. You do not need to fill out the form if your child is not taking any medications.
Camper First Name
Camper Last Name
Name of Adult Checking Camper In
Weeks Attending Camp (check all that apply)
Week 1 (June 3-9)
Week 2 (June 10-16)
Week 3 (June 17-23)
Week 4 (June 24- June 30)
Week 5 (July 1- 7)
Week 6 (July 8-14)
Dosage (1 tablet, 2 sprays, etc.)
Time of Day to Administer (check all that apply)
Breakfast (8 am)
Lunch (12 pm)
Dinner (5 pm)
Bedtime (between 9-10 pm)
Other (fill in next question)
Helpful Medication information for Camp Staff
Does your camper have another medication?
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