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2023 6th Grade Camp - Pain Medication Permission Form

The ICD staff can administer pain medication to your child while at camp with your permission. Please complete the form below. Required fields marked with an asterisk *

First and last name of parent submitting this form.*

Answer Required

I give my permission for ICD staff to administer the following type of pain medication to my child while at camp.*

We will have children's and adult formulas available. Medications will be given according to package directions.

Answer Required

Student First Name*

Answer Required

Student Last Name*

Answer Required

Student Weight*

Answer Required

Confirmation Email

Confirmation Email *

Email Required