• Camper Medical Information

    Rainbow's End Day Camp
  • Camper's Date of Birth*
     / /
  • Format: (000) 000-0000.
  • Drug Allergies*
  • Non-Drug Allergies*
  • Rows
  • Rows
  • Does camper have seizures or convulsions?*
  • Date of last seizure
     - -
  • Current health conditions requiring medication, treatment or special consideration while at camp
  • Will camper be receiving medication while at camp?*
  • If yes, please fill in the medication information below*
  • Rows
  • Date of Signature*
     / /

  • When camper arrives at camp, the nurse will collect all medications. All prescription medication must be in its’ original container with the name of the medication, dosage, Pharmacy name, Physician’s name, and time medication is to be taken. Any over the counter medication must be in its’ original package with campers name on it. Any unused medication will be returned at the end of the week.

  • Should be Empty: