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Camper's First Name
Camper's Date of Birth
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Phone
Camper's Last Name
Camper's Age
phone type
Email Address
Emergency Contact First Name
Emergency Contact Last Name
Emergency Contact's Phone
Does the camper have any allergies?
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Yes
No
Please explain
Does the camper require a special diet?
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Yes
No
Please explain
Will the camper be using any medication or over-the-counter drugs?
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Yes
No
Please explain
Does the camper have a chronic or recurring illness?
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No
Please explain
Has the camper had surgery or a serious illness in the last 12-months?
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No
Please explain
Other physical limits or accomodations:
Permission
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Camper Conduct
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Disclaimer Clause
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Description of RISKS
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RELEASE OF LIABILITY WAIVER OR CLAIMS AND INDENMNITY AGREEMENT
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Media Release
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Camper Signiture
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Date of signing
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Guarding Signiture (if under 18)
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Date of signing
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