Health Form | FrogTennis

Camper First Name

Camper Last Name

Date of Birth

Month

Day

Year

Parent of Guardian Name

Relationship to Camper

Phone

Does your child have medical conditions that we should be aware of (e.g. asthma, peanut allergy)

Yes

If yes, please elaborate:

Are there any restrictions or limitations for your child during camp?

Yes

If yes, please elaborate:

If I am not available in an emergency, please contact:

Emergency Contact Phone

I have read and agreed to the frog Hollow Racquet Club Program Agreement, Release, Assumption of Risk, Waiver of Liability and Right to Sue and Indemnity/Hold Harmless agreement and EFT Authorization.

I confirm the information given in this form is true.

Signature of Parent or Gaurdian

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