Central Iowa Color Guard Camp Emergency Contact Form
Please fill out the document below with as much detail as possible. We want to be certain your child is safe while attending our camp. Having quick access to this information in case of emergency is important in that regard. Should any such emergency occur, we will contact the listed emergency contacts in order of preference listed here.
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Participant's First Name
Participant's Last Name
Emergency Contact #1--Legal Guardian Contact #1(Please provide name and phone number)
Emergency Contact #2--Legal Guardian Contact #2(Please provide name and phone number)
Emergency Contact #3--Someone to contact in case 1 and 2 are not available. (Please provide name and phone number)
Please list any health conditions your child may have that we should know about: allergies, medications, things we would need to convey to a doctor in an emergency.
Date of most recent tetanus shot:
Allergic reactions to medications, please be specific and include type of reaction:
Please list any medications your child currently is prescribed, the dosage and how often they take it.
By typing my name below, I certify that I am the participant's legal guardian and I authorize and permit the representatives of the Central Iowa Color Guard Camp to secure medical treatment which the participant named above may require or which may be reasonably necessary for such participant while at the above mentioned camp. I also understand that I will be responsible for all medical costs which will be incurred.
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