Medical Form for Minors

Parents: We take your child’s safety extremely seriously. Our RA carries contact and medical information on her at all times in case of emergency. Please fill out this form as soon as possible. Thank you!

Strings Without Boundaries MEDICAL FORM

  • This address form might confuse you because it provides a box for the address below the word "Address" but the zip code should go in the box above the phrase "zip code." So much for automated technology… Well, at least you don't have to fill out a form by hand!
  • Number each medical condition. Hit return for each additional condition to create an easy-to-read list. Or type "none."
  • Please list any medications that may need to be administered during the camp along with instructions for administration. Here is an example: 1. antibiotic (name of antibiotic): 1 pill after breakfast, 1 after dinner. 2. Asthma medication (name of medication): Only to be used when needed. Etc. OR TYPE "NONE"
  • Medical Treatment Consent for Minors:

    Medical Treatment Consent for Minors If your child will be under age 18 while at Strings Without Boundaries at Lawrence University, it is camp policy to secure your consent for medical treatment or medication distribution and for the use of medical devices. All medications must be in a medicine bottle and labeled with the camper’s name, doctor’s name and phone number, medication name, and dosage. Also, please complete the following for each medication. Emergency medications such as inhalers, bee sting kits, or insulin may be kept with the student. All other medications will be stored by camp staff.
  • I understand that typing my name where indicated will carry the same legal weight as a signature.