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Giving
Maywood Summer Camp
Please fill out the form below to register your child for day camp. Up to four children per form.
Parent or Guardian First and Last Name
Email Address
I grant permission for the children listed to participate in Maywood's Summer Camp to be held at "The Woods" (formerly Camp AWANA), in Fredonia, Wisconsin, beginning Monday, August 7 through Friday, August 11, 2023. I understand that sufficient adult supervision will be provided, and I acknowledge that I have submitted a 2022-2023 Medical Release Form, providing information to be used in the event any medical decisions need to be made.
I grant permission for The Woods' Licensed Medical Professional to dispense medicine, as indicated below, and administer first aid and medical transport as needed to said camper beginning Monday, August 7 through Friday, August 11, 2023.
-Prescribed medication needed during summer camp brought in its
original packaging
inside labeled zip lock bag. Epi-pens, inhalers, and other rescue devices will be held by the camper (or his/her leader).
-Vitamins or other over-the-counter medications need to be in
original packaging
with expiration dates visible.
No expired medications can be administered. No pill boxes from home!
-Other over-the-counter medication approved by The Woods may be distributed as needed as well. Examples include: cream for various rashes, upset stomach pills, acetaminophen (Tylenol), ibuprofen (Advil, Motrin), etc.
The medication will be dispensed if, in the considered opinion of The Woods' Licensed Medical Professional, it is necessary and in the dosage directed on the medication packaging.
Child #1
Child's First and Last Name
Gender
Girl
Boy
Birthdate
Last grade of school completed
T-Shirt Size
Youth Small
Youth Medium
Youth Large
Youth X-Large
Adult Small
Adult Medium
Adult Large
Adult X-Large
Child is bringing Medications
No
Yes
Name of medication
Dosage
Frequency (including time of day to administer)
Other medical concerns/conditions/allergies for this child
Child #2
Child's First and Last Name
Gender
Girl
Boy
Birthdate
Last grade of school completed
T-Shirt Size
Youth Small
Youth Medium
Youth Large
Youth X-Large
Adult Small
Adult Medium
Adult Large
Adult X-Large
Child is bringing Medications
No
Yes
Name of medication
Dosage
Frequency (including time of day to administer)
Other medical concerns/conditions/allergies for this child
Child #3
Child's First and Last Name
Gender
Girl
Boy
Birthdate
Last grade of school completed
T-Shirt Size
Youth Small
Youth Medium
Youth Large
Youth X-Large
Adult Small
Adult Medium
Adult Large
Adult X-Large
Child is bringing Medications
No
Yes
Name of medication
Dosage
Frequency (including time of day to administer)
Other medical concerns/conditions/allergies for this child
Child #4
Child's First and Last Name
Gender
Girl
Boy
Birthdate
Last grade of school completed
T-Shirt Size
Youth Small
Youth Medium
Youth Large
Youth X-Large
Adult Small
Adult Medium
Adult Large
Adult X-Large
Child is bringing Medications
No
Yes
Name of medication
Dosage
Frequency (including time of day to administer)
Other medical concerns/conditions/allergies for this child
Submit
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Maywood Free Church