Frog Hollow Summer Camp Health Form

All campers must have a completed health form by June 1st to be allowed to participate in camp.

Camper First Name

Camper Last Name

Date of Birth

Parent or Guardian Name

Contact Phone

Your Relationship to Camper

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

Yes

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

Yes

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

Emergency Contact Phone

Your Signature

I confirm that the information given in this form is true

Thanks for submitting!

I have read and agreeed 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.