In case we can't get hold of you in the event of an emergency, please enter the next person to contact and their phone number.
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Participants/Guardians Responsibilities and Agreement: No representation or warranties have been made other than those contained in the flyer, brochure, or webpage. We have read and agree with all terms and agreements as stated. *
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Medical Information *
Please list below any Health Concerns or Medications that staff should be aware of regarding your child.
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Physician Name *
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Physician Phone *
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Health Insurance Carrier *
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Health Insurance Policy # *
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Medical Problems: Please list any medical problems, medications, allergies, and/or treatments required for your child. *
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Emergency Treatment: Do you authorize us to contact paramedics in the event of a medical emergency? *
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By clicking on Submit below, you are agreeing to all conditions as listed on the Odyssey Adventure Club Camp Policies Form/Webpage; clicking Submit constitutes your signature for agreement with all policies. *