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Camper Information Form

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  • Privacy notice: This information is needed to alert camp administration of the medical needs of the camp population. It will be treated as confidential medical information, and will be given to appropriate medical service providers in case of an emergency. Failure to provide this information will result in the camper not being allowed to attend camp.

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  • Please include Over the Counter and Prescription medications and be sure to obtain your doctor's signature for all on Physician Approval for Medication at Camp form.
  • MM slash DD slash YYYY
  • Please provide medications in their ORIGINAL CONTAINERS with the actual prescription, plus a signed doctor's note, and instructions attached.  Please include situational medications such as inhalers and epi-pens in this list as well.  Please print and provide your doctor with our Physician Approval for Medications at Camp form if needed.

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Office: 61 O’Neil Street
Kingston, NY 12401
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