Medical History/check-Out Permission Form Page 7
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8CAMP POLICY FOR MEDICATION
For the safety of our students, we have a strict policy for the handling of medication at camp. Our
medication policy changes and evolves each season. If your child will be taking medication while at
camp, please be sure to follow the specific procedures listed below. Please note: Students will not be
admitted to camp if these procedures are not followed.
•
We ask that students attending camp please take ALL medication and/or vitamins before camp,
unless they MUST be taken during camp hours.
•
ALL medication MUST be brought to camp in their ORIGINAL CONTAINERS on your child’s
first day of camp. Please do not take the medication out of the container.
•
The original container must identify (in English) the prescribing physician (if a prescription
drug), the name of the medication, the dosage and the frequency of administration.
•
Students will be responsible for self administering medication in accordance with the instructions
below. In the case of emergency, or the camper cannot administer the medication themselves, a
camp staff member will assist.
•
Students needing injections (insulin, hormones, etc.) will need to self-administer the medication.
Camp staff are not trained in this area.
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All medication information MUST be completely entered in your child’s Health History form.
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It is the responsibility of the Parent/Guardian to pick up any remaining medication at the end of
the week. Any medication and/or vitamins left at camp will be disposed of.
AUTHORIZATION TO ADMINISTER MEDICATION
I HEREBY AUTHORIZE the designated representatives of The Watersports Camp to administer the medication described
below. It is the policy of MBAC to provide the medicine to the camper to self administer in accordance with instructions below.
Should the camper be unable to administer the medication themselves, a staff member will assist in the administration. In
consideration of the administration of this medication in accordance with the direction’s of my child’s doctor, I hereby release
The Watersports Camp and its agents or representatives or employees from any and all liability for damages resulting from the
administration of this medication to my child. I further agree to hold harmless and indemnify MBYWSC and its agents or
representatives or employees from any costs or expenses associated with any claim brought against them for actions taken
pursuant to this Authorization to Administer Medication and such indemnification to include attorney fees, costs of any litigation
or claim or any damages or out of pocket costs occasioned by The Watersports Camp, its agents or representatives or
employees.
__________________________________________________
_____________________
Child’s Name
Date
__________________________________________________
_____________________
Parent/Legal Guardian*
Date
__________________________________________________
_____________________
Prescribing Physician
Physician Phone
Medication #1: _____________________________________________ Dosage: ____________________
Time taken:________________________________ Reason for taking:____________________________
Medication #2: _____________________________________________ Dosage: ____________________
Time taken:________________________________ Reason for taking:____________________________
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Parent category: Medical