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  (818) 706-8255 ~ (805) 523-7711

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On-line Camper Health Form

Your completion of the on-line Camper Health Form does NOT require a visit to your pediatrician.
All campers must have a completed 2012 Camper Health Form on file in order to attend camp.


Completing your Camper Health Forms is easy!

The health form will be available beginning in March.
Please check back then.


Please ensure that you have the following information available.


  1. Immunizations:
    • Please confirm that Polio and MMR immunizations are current. (Yes or No)
    • Please have the actual month and year of the last tetanus shot or DPT. (Required)

  2. Emergency Contacts:
    You will be asked to provide the name and cell phone number for two different emergency contacts that camp should try to reach if we cannot reach you or your spouse in the event of an emergency. (Space will be provided for home and work numbers as well.) One of these people should routinely be within 30-45 minutes of camp during the camp day.

  3. Who is permitted to pick up your campers at the bus?
    You will need the first and last names of people who may pick up your camper(s) from camp or the bus stop in your absence. Commonly parents provide us with the names of relatives and/or the mother of one of their camper's friends. This is ideal, and we've learned from experience to ask for one more thing. If you are listing one parent of your camper's friend, please list both of his/her parents because sometimes the unexpected parent is called upon to pick up and if they (usually dads) are not specifically listed on your release list, we cannot assume that you give that person permission.

  4. Insurance Information:
    Insurance Carrier, Insurance ID#, Group Number, Carrier Address (if known), Name of Insured, Relationship to Camper.

The health form will be available beginning in March.
Please check back then.