HEALTH & EMERGENCY CARE

RELEASE FORM

  • Camper Information

  • Parent/Guardian Information

  • Emergency Contacts

    In case we cannot reach the Parent(s)/Guardian(s) listed above, please provide emergency contacts:
  • Pick-Up Authorization

    Please list all adults (including parents) authorized to pick up your child:
  • Medical Information

    Due to the public nature of our site, we cannot guarantee that the area is peanut/nut free.
  • Special Needs

    Does your child have any special behavioral or physical needs? Please share information about your child’s mental, emotional and physical health that will enable us to better serve him/her, and describe strategies you’ve found effective in addressing this need.
  • Catamount Outdoor Family Center Release Statement

  • Date Format: MM slash DD slash YYYY
  • This field is for validation purposes and should be left unchanged.