Camper Health History Form

Harford Gymnastics Summer Camper Health History Form. Please submit this completed form separately for each child attending camp.

Camper Information
First Name
Last Name
Emergency Contact Information:
First Name
Last Name
Health Information
All medications must be self administered. You must have your child's physician complete a medication authorization form and return to our office at least 7 days prior to their first day of camp.
Please indicate if the camper's allergy requires them to be isolated out of the lunch room or separated due to an allergy - free table in the lunch room from the other campers during meals.
Immunization Information
All campers who reside outside of the United States, must provide our office with a completed DHMH-896 form (record of vaccination or immunization) 7 days prior to their first day of camp.
You must provide documentation of their exemption 7 days prior to their first day of camp.
Your Information
First Name
Last Name
This form must only be completed by a parent or legal guardian of the child attending camp.
1 + 10 =
Solve this simple math problem and enter the result. E.g. for 1+3, enter 4.

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