Camp Rise & Sign 2023 | Registration

Medical Information
Please list all known medical conditions.*
asthma, allergies, etc.
Is camper on medication?*
Is camper ALLERGIC to any medication?*
If yes, what medication(s):
medication camper is on
If yes, what medication(s):
medication camper is allergic to
Please note that all medications must be listed. Please understand that campers cannot keep their medications. A staff member will collect and distribute daily medications.
Is participant currently under the care of a doctor? If so, please include doctor's name & phone number.

Releases & Consents
Media Release

I give my permission for Bridges to allow photographs or interview statements of my child to be used as part of any publicity coverage that may occur including newsletters, public relations materials, or coverage by area media in regard to Bridges’s youth center programming.
*

yesno
Please Sign & Date*

Clear
Activity Consent

During Camp Rise & Sign, the camper will have the opportunity to participate in various activities including: arts and crafts, sports and games, educational seminars, and outdoor activities. As a parent/guardian, I understand the nature of these activities and give permission for my child to participate.
Please Sign & Date*

Clear
Swimming Consent

My child will have an opportunity to participate in group swimming activities. As a parent/guardian, I understand the nature and risks of this activity and give permission for my child to participate.
Please Sign & Date*

Clear
My child's swimming ability:
COVID-19 Protocols

If transmission rates are medium to high, we will ask campers to have a negative test before attending.
Has your child been vaccinated against COVID-19?

yesno
Please Sign & Date*

Clear

We ask that you complete a form for each child, but please list the name(s) of other campers here for reference:
Should be Empty:

Medical Information