Summer Camp Health Form

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Please complete one health form per enrolled camper. If you have multiple children attending the camp, please fill out a separate form for each child. Forms with multiple information for multiple students will be returned to the sender to be corrected.

All campers MUST have a completed health form turned in by the first day of camp. If you do not complete a health form during registration, you will be instructed to move to a separate line to complete any missing paperwork.

Please email marco.bazan@austinisd.org if you have any questions, comments, or concerns.

Email *

Child's Name (First and Last) *

Parent Name (First and Last) *

Does your child have any allergies? *

Yes

If you answered yes to question 3: What allergies does your child have?

If you answered yes to question 3: What is the severity of that allergy

If you answered yes to question 3: What type of reaction does this allergy cause if triggered?

Are there any health conditions that we should be aware of? Asthma, skin conditions, coping strategies, etc. *

Please provide TWO emergency contacts (First/Last Name and a phone number) that we can contact you at immediately in case of an emergency. *

Send me a copy of my responses.

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