Participant Information

Please fill out the following form as detailed as possible. Information given will be treated with the strictest confidentiality. Any vague or incorrect information could result in the injury or death of yourself or to other participants.

Emergency Contact Information

In case of emergency, please contact

Vital Information

H2o Dreams Administration of Medication Authorization

We encourage all parents/guardians to administer all physician prescribed medication(s) to their child before or after a H2o Dreams sponsored program. However, we understand that some cases may arise when the day camp’s part-time/full-time supervisor may be requested to administer medication. By completing the information below, the H2o Dreams part-time/full-time staff is authorized to administer physician prescribed medication(s) that are stored in a current prescription bottle(s).

 

H2o Dreams part-time/full-time staff is authorized to administer physician prescribed medication (s) that are stored in a current prescription bottle(s)

List medication(s) to be administered

H2o Dreams Camper Release Authorization Form

H2o Dreams campers may only leave with an authorized person carrying a valid ID, age 16 or older that are designated in the H2o Dreams Camper Release Authorization Form.

 

Main pick-up person:

Additional persons who may pick up child/children on a less frequent basis:

Note: Any person unfamiliar to H2o Dreams staff will be required to show proof of identification. Under NO circumstances will the child be released to anyone other than those listed above without WRITTEN permission from the parent.

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