201 Day Camp Medication Form
Camper's Full Name
Over the Counter Medications (OTC)
Please check each individual medication that we may give your camper if she should need medication while at camp. CHOOSE "ALL OTC MEDS" if applicable. NOTE: All medications are given based on your individual child's weight or age as listed in the instructions.
ALL OTC MEDS LISTED may be given
Acetaminophen (such as Tylenol or other non-aspirin pain reliever)
Ibuprofen (Motrin, Advil)
Antihistamine (such as Benadryl)
Calamine, Caladryl or other anti-itch lotion
Antibiotic Ointment (such as polysporin or Neosporin)
PRESCRIPTION MEDICATIONS: We can only administer prescription medication according to directions on the label unless we have a signed doctors note!
Please fill in for any prescription medications your camper will be bringing to camp. Please include for each medication the DOSE/REASON/TIME & Day to be given
What is your name?
Please enter your name as the person filling in this form and authorizing administration.
I authorize the administration of the identified medications from 7/23-7/26 at WDC
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