C.A.P.S. Summer Enrichment Camp Application 2024

Student Information

School Information

Parent / Guardian Information

Student Interest (select 2 only)

Emergency Contact Form

Emergency Medical Treatment: In the event of an emergency, I hereby give permission to transport my child to a hospital by car or ambulance for emergency medical or surgical treatment. I wish to be advised prior to any further treatment by the hospital or doctor.  In the event of an emergency, transport my child to:
Medications: My child is taking medication at present. My child will bring all such medications necessary, and such medications will be well labeled. Names of medications and concise directions for seeing that the child takes such medications, including dosage and frequency of dosage is as follows:

Special Medication Information