Jr. Week 2018 MALE Registration

You are registering as a MALE for MSC Jr. Week 2018.  Please expand each section and provide the requested information
Camper Information
How old will you be on Aug. 1?
Camp Information
What grade will you be in this fall?
How many times have you attended MSC before?
Parent / Guardian
Insurance Information
Proof of insurance MUST BE PROVIDED in order for your child to attend
Medical Information
Medical conditions or purpose of medications (e.g. Diabetes, skeletal, neurological, cardiac, behavioral, allergies, etc.)
List prescribed and over the counter medications. If there are medications, the Conditions are also required.
Known food or drug allergies
Physician
YesNo
Tylenol
Ibuprofen (Advil)
Aleve
Maalox or Pepto-Bismol
Imodium
Neosporin Ointment
Benadryl (oral/cream)
Non-Drowsy Allergy Relief
Please check all medications which our medical staff may give to your camper. We will not administer any of these without your approval.
Date of last tetanus booster vaccination. Leave blank if unknown
Emergency Pickup
Names and phone numbers of those allowed to pick up the child in case of medical need or other situation while camp is in session. (Upon arrival, this person must present proof of identity before a camper will be released to their care). NOTE: Campers will be allowed to leave camp only with parent /guardian or the below designated parties. Campers WILL NOT be allowed to leave with anyone else until camp is concluded.
Any additional comments you need to provide