MFCC Medical Release

Name of Camper *

Which Session? *Sr. Session (7th-12th Grades)Jr. Session (3rd-6th Grades)

Name of Parent *

Parent Phone Number *

List of Camper's Allergies

List of Camper's Medications

My Child has the following disabilities/injuries

Emergency Contact 1

Name *

Phone *

Relation to Camper *

Emergency Contact 2

Name *

Phone *

Relation to Camper *

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