EMERGENCY CONTACT CARD CAMPER'S FULL NAME * First Name Last Name DATE OF BIRTH * MM DD YYYY ANY ALLERGIES OR MEDICAL CONDITIONS? * ANY MEDICATIONS TAKEN BY CAMPER? * PARENT / GUARDIAN 1 * First Name Last Name PHONE * (###) ### #### RELATIONSHIP * PARENT / GUARDIAN 2 First Name Last Name PHONE (###) ### #### RELATIONSHIP EMERGENCY CONTACT (OTHER THAN PARENT) * First Name Last Name PHONE * (###) ### #### RELATIONSHIP * PICK-UP AUTHORIZATION USE THIS FIELD TO ADD A PERSON AUTHORIZED TO PICK UP THE CAMPER PICK-UP AUTHORIZATION USE THIS FIELD TO ADD A PERSON AUTHORIZED TO PICK UP THE CAMPER T-Shirt Size * Youth X-Small Youth Small Youth Medium Youth Large Youth X-Large Small Medium Large X-Large 2X-Large Thank you!
