This information is for internal
purposes only. Personal details are never shared.
* Please enter birthdate at time of camp.
ALLERGIES OR OTHER MEDICAL INFORMATION
If a camper has an anaphylactic allergy, e-mail or mail a copy of the camper's allergy action
plan, CISFSailing@gmail.com or mail to: 7 Felucca Avenue, Jamestown, RI 02835. We cannot
guarantee that any area at camp is allergen-free.
Has/Does the camper:
1. Ever been diagnosed with attention deficit disorder (ADD) or attention deficit hyperactivity disorder (ADHD)?
2. Ever been treated for emotional/behavioral difficulties, self-harm, or an eating disorder?
Please explain "Yes" answers in the spaces above. Contact the Camp Coordinator to provide additional information if needed or fill in space below. To better care for your camper: Please provide any additional information about the camper's behavior or physical, mental, emotional, and social health that you think is important or that may affect the camper's ability to participate in the Camp program (shyness, learning style, etc.) List any strategies used to manage the concern or enhance the camper's ability. This information will only be shared with Sea Adventure Instructors on a need to know basis.
MEDICATIONS AT HOME
MEDICATIONS AT CAMP
Include any medication that the camper may need to take at camp, including vitamins, Lactaid, etc. Attach additional pages if needed. The camper's parent/guardian must supply these medications, labeled with the camper's name, unexpired and in original containers, and bearing specific directions for administering. Prescription medications must have the full pharmacy label. Contact the camp coordinator if a camper takes medication for mental health and the medication or dose has changed within the three months prior to camp.
ASTHMA EMERGENCY MEDICATIONS
Mail or e-mail a copy of the camper's asthma action plan - CISFSailing@gmail.com or mail to: 7 Felucca Avenue, Jamestown, RI 02835. Contact the camp coordinator if you have any questions.
ALLERGY EMERGENCY MEDICATIONS
Mail or e-mail a copy of the camper's allergy action plan - CISFSailing@gmail.com or mail to: 7 Felucca Avenue, Jamestown, RI 02835 Provide two EpiPens bearing the original pharmacy labels.
Please use this section to tell us anything that you feel will help your child have a positive experience with at camp; or any medical information or learning strategies that are successful with your child.