Online Registration Form - CHS Adventure Camp July 8th-13th 2018 @ Camp T

All infornation in this form is strictly confidential and will only be viewed by our medical personnel and the camp director.

Please fill in all blanks spaces that are marked as important (*) with an N/A if it does not apply to your child.

Camper's Contact Information
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Camper's Details
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Take a moment please

Please take a moment and tell us about your child. Especially, if there is anything that our camp counselors should know to help make camp more enjoyable for your child

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Payment Information – Non-Bleeding Disorder

One week of camp for any Non-Bleeder children is $350.00 per child, tax incl. Deposit is non- refundable. One form per child must be filled out. If your child is bringing a Buddy, please have the Parent/Guardian of that child fill a separate registration form. We do offer a family discount for any brothers/sisters that would like to attend camp.

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Payment Information – Bleeding Disorder

One week of camp for all Bleeder children is Free. However, we do accept donations if you are able to do so and a Tax receipt will be given at registration. One form per child must be filled out.

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Camper Medical Information
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Camper Medical Details
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Medical Information

Be sure to bring all medications in the orginal bottles labeled with the child's name, the name of the medicine in the bottle, and directions for giving it. All perscription medications must have the orginal label containing your child's perscription.

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IMPORTANT NOTICE From Nurses

Inorder to enable the camp Nurses to provide the best care for your child, upon registration the nurses will examine all campers for any bruising or signs of bleeding.. This included non-bleeder children and bleeder children.

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Nurse Notes:

If your child has been in contact with anything communicatible (e.g. impetigo, hand/foot/mouth disease), please notify your local clinic prior to camp.

To prevent disappointment to your child, we suggest yu have your child's head checked for lice prior to camp. If your child fails the registration head check for lice, he/she WILL NOT be permitted to stay.

Bleeding Disorder Form - Blood Disorder Children ONLY
This form is only to be filled out by parents that have a child affected with a bleeding disorder.

Please be advised that the bleeding disorder nurses will be using this time at camp to educate your child on his/her bleeding disorder and will encourage them to learn self-infusion if appropriate. If you have any issues with your child learning self infusion at camp please make sure to fill in the bottom of this form with your response.

Each camper must bring all supplies and medications that they require at camp and give these to the bleeding disorder nurses on our camp site at registration.

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Snider Mountain Waiver Form
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CHS Consent & Release Form
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CHS Consent & Release Form
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