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Medical Release Form

THIS FORM MUST BE COMPLETED AND RETURNED TO US IF YOU KNOW YOUR CHILD WILL NEED PRESCRIPTION OR OVER THE COUNTER MEDICATION DISPENSED AT CAMP. If not, save it for use during the summer if needed.

ALL medications (whether PRESCRIPTION OR OVER THE COUNTER) shall be brought to Camp by the parent/guardian or BUS COUNSELOR and shall be sent home when the medication is no longer needed or at the end of camp.

“Medication” shall include ALL medicines prescribed by a physician for the particular camper, including emergency medication in the event of bee stings, etc. and ALL over the counter medications. Before any medications may be administered to any camper during camp, we REQUIRE the WRITTEN REQUEST of the PARENT/GUARDIAN who shall give permission for such administration. In addition, we also REQUIRE the WRITTEN ORDER of THE PHYSICIAN (EVEN for OVER THE COUNTER MEDICATION) which shall include:

  • A. The purpose of the medication
  • B. The dosage, in original containers, specifically labeled
  • C. The time at which or the special circumstances under which the medication shall be administrated
  • D. The length of time for which medication is to be taken
  • E. The possible side effects of the medication

 

    • The camp nurse has permission to administer the above mediation as prescribed.