SayPro 5-Day Faith-Based Camp Health and Safety Form.

SayPro 5-Day Faith-Based Camp Health and Safety Form

Thank you for registering your child for the SayPro 5-Day Faith-Based Camp! To ensure a safe and healthy experience for all participants, we require the following health and safety information. This form will gather important details about your child’s medical history, allergies, and emergency contacts. Please fill out the form accurately and completely. All information will be kept confidential.

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Participant Information

1. Full Name of Participant:
   [Text Field]
2. Date of Birth:
   [Date Picker]
3. Age (at time of camp):
   [Auto-calculated from Date of Birth]
4. Gender:
   [Dropdown Menu: Male, Female, Non-Binary, Prefer Not to Say]

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Parent/Guardian Information

1. Full Name of Parent/Guardian:
   [Text Field]
2. Relationship to Participant:
   [Text Field]
3. Phone Number (Parent/Guardian):
   [Text Field]
4. Email Address (Parent/Guardian):
   [Text Field]

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Emergency Contact Information

Please provide contact information for two individuals who can be reached in case of an emergency during the camp.

1. Emergency Contact 1 Name (Full Name):
   [Text Field]
2. Emergency Contact 1 Relationship to Participant:
   [Text Field]
3. Emergency Contact 1 Phone Number:
   [Text Field]
4. Emergency Contact 2 Name (Full Name):
   [Text Field]
5. Emergency Contact 2 Relationship to Participant:
   [Text Field]
6. Emergency Contact 2 Phone Number:
   [Text Field]

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Health Information

To ensure that we can respond appropriately to your child’s health needs, please provide details about their medical history.

1. Does your child have any allergies?
   [Dropdown Menu: Yes, No]
   If yes, please list the allergies (food, environmental, medication, etc.):
   [Text Field]
2. Does your child take any daily medications?
   [Dropdown Menu: Yes, No]
   If yes, please list medications, dosages, and the time of day they should be administered:
   [Text Field]
3. Does your child have any chronic conditions or health concerns (e.g., asthma, diabetes, epilepsy, heart condition, etc.)?
   [Dropdown Menu: Yes, No]
   If yes, please describe the condition(s) and necessary treatment or accommodations:
   [Text Field]
4. Does your child have any special dietary needs or restrictions (e.g., vegetarian, gluten-free, halal, kosher)?
   [Dropdown Menu: Yes, No]
   If yes, please specify:
   [Text Field]
5. Has your child been hospitalized in the past year or undergone any major surgeries?
   [Dropdown Menu: Yes, No]
   If yes, please provide details:
   [Text Field]
6. Does your child have any mental health conditions or concerns that may affect their participation in the camp (e.g., anxiety, depression, ADHD)?
   [Dropdown Menu: Yes, No]
   If yes, please provide details and any accommodations needed:
   [Text Field]
7. Does your child have any mobility issues or other physical needs that may require special accommodations during the camp?
   [Dropdown Menu: Yes, No]
   If yes, please provide details:
   [Text Field]
8. Has your child received all recommended vaccinations, including flu and COVID-19 vaccines (if applicable)?
   [Dropdown Menu: Yes, No]
   If no, please specify any vaccinations that are pending:
   [Text Field]
9. Does your child have any other health concerns or information that we should know about to ensure their safety and well-being during camp?
   [Text Field]

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Consent for Medical Treatment

In the event of a medical emergency, SayPro camp staff may need to seek medical treatment for your child. Please review and sign the consent below.

1. I, the undersigned parent/guardian of the participant, give permission for SayPro camp staff to seek emergency medical care for my child in the event of an illness or injury during the camp.
   [Checkbox: I agree]
2. In the event of an emergency, I understand that camp staff will attempt to contact me first. If I cannot be reached, I give permission for my child to be treated by a licensed physician or at a hospital if necessary.
   [Checkbox: I agree]
3. I understand that I am responsible for any medical expenses incurred due to the treatment of my child.
   [Checkbox: I agree]

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Authorization for Medication Administration (if applicable)

If your child requires medication to be administered during camp, please provide details and consent below.

1. Does your child need to take medication during the camp?
   [Dropdown Menu: Yes, No]
   If yes, please list the medications, dosages, and administration instructions:
   [Text Field]
2. I authorize SayPro camp staff to administer the prescribed medication to my child as needed.
   [Checkbox: I agree]

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Parental/Guardian Acknowledgement

By completing this form, I acknowledge that all the information I have provided is accurate to the best of my knowledge. I understand that it is my responsibility to notify the camp if any of the participant’s health information changes prior to the camp. I also agree to abide by the camp’s policies and understand the importance of providing complete and honest information regarding my child’s health and safety needs.

1. Parent/Guardian Signature:
   [Digital Signature or Checkbox: I agree]
2. Date:
   [Date Picker]

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Submit Health and Safety Form

Once you have completed the form, please click the “Submit” button below to submit your child’s health and safety information.

[Submit Button]

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Thank You for Your Cooperation!

Thank you for taking the time to complete this important Health and Safety Form. We prioritize the well-being and safety of all our campers, and your cooperation helps us provide a secure and enjoyable camp experience. If you have any questions or need to update this form in the future, please contact us at [Insert Contact Information].

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This Health and Safety Form Template ensures that all relevant medical and health information is gathered in advance of the SayPro 5-Day Faith-Based Camp. The form allows camp organizers to safely and responsibly manage participants’ health needs while maintaining a safe environment throughout the event. It includes details for allergies, medications, medical conditions, emergency contacts, and consent for medical treatment.