Merrimack Valley YMCA
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Camps

Camp Nokomis Medical Form

   

Our camp needs medical information to properly identify health care needs of the camper.  The Health History (two pages) should be filled out by parents/guardians of minors, or by adult staff themselves, and the Examination form page must be completed by an appropriate Licensed Medical Person.  

BOTH forms (health history and examination) must be at camp 2 weeks prior to camper's arrival.


FYI:

In 2003 the State of New Hampshire changed its law on the carrying of inhalers and EpiPen Auto Injectors. If your child, due to health reasons, must carry either of these items, please contact us for the release form you and your physician must sign before your child, by law, can carry these devises. The new laws are online - NH laws: HB0057 and HB0092 or we can send you a copy on request.

Read Safety Regulation Section 485-A:25-b
Read Safety Regulation Section 485-A:25-f



Mail Camp Nokomis Forms to:

Camp (Nokomis or Lawrence) Nurse
Bear Island via Mailboat
Laconia, NH  03246