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HealtH History Form - West Suburban YMCA - westsuburbanymca 2026

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The document is a Health History Form for campers at the West Suburban YMCA, which must be completed by a parent or guardian. It requires detailed information about the camper's health history, including allergies, medications, and emergency contacts. Additionally, it outlines necessary documentation such as a recent physical exam and immunization records. The form also includes sections for parental authorization, payment details, photography consent, and a release of liability. It emphasizes the importance of providing complete and accurate information to ensure the camper's safety and well-being during camp activities.

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Click ‘Get Form’ to open it in the editor.
Begin by entering the camper's name and home address at the top of the form. Ensure all fields are filled accurately.
Provide birth date and complete the Parent/Guardian information sections. Include contact details for both guardians, ensuring clarity on who has legal custody.
Fill in emergency contact details, including additional contacts authorized for pick-up. This is crucial for safety and communication.
Complete the camper's physician and dentist information, followed by insurance details. Make sure to indicate if the camper has medical coverage.
Detail any allergies or medical history in the designated sections. Be thorough to ensure proper care during camp.
Review all entries for completeness before signing at the end of the form. Remember that incomplete forms will be returned.

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