Registration Health Forms

Creative Summer adheres to all health guidelines and requirements set forth by the Maryland Department of Health and the Montgomery County Health Department. In accordance with health department policies, Creative Summer must have the proper health forms on file for each camper. Please review the Health Form descriptions below to determine which forms, if any, are necessary for your camper.

All health forms must be submitted to the Creative Summer Office by Tuesday, April 30, 2019.

Camper Health History Form

Camper Health History Form is incorporated into the online registration form and is submitted when you register and submit your $150 non-refundable deposit. You will be required to provide insurance and emergency contact information.

All other Health Forms, if needed, are due Tuesday, April 30, 2019.

Immunization Certificate/MDH Form 896

Immunization Certificate/MDH Form 896Required by a FEW campers.

Submit this form if your camper resides OUTSIDE the United States, OR your camper is exempt from any immunization for medical or religious reasons. This form requires a physician signature unless camper is exempt from immunization on religious grounds.

Creative Summer cannot accept immunization record or exemption certificates in any format other than MDH Form 896.

Campers who require this form must have it submitted before they may attend camp.

Medication Administration Authorization Forms

Medication Administration AuthorizationNeeded by SOME campers.

Submit a Medication Administration Authorization (MAA) if your camper requires daily or emergency medication, including Over-the-Counter medication provided by the family. For each medication and/or EpiPen you provide for your camper, you must submit a corresponding MAA with both physician and parent signatures. Three forms are available:


OTC Medication Authorization

Over-the-Counter Medication AuthorizationOPTIONAL but recommended.

Submit this form to authorize our Camp Nurse to administer certain Over-the-Counter medications (listed on the form) to your camper for minor injuries/illnesses as-needed. These medications are provided by the camp. This OPTIONAL form requires both physician and parent signatures, and your physician must specify the medications and dosage your camper may take.

Sunscreen Authorization

Sunscreen AuthorizationOPTIONAL.

Submit this form if your camper will apply sunscreen during the camp day. List acceptable brand(s) of sunscreen and indicate whether our adult counselors may assist your camper in sunscreen application. Submit one copy to the Creative Summer office and keep a copy with the sunscreen. You must provide the sunscreen in its original container with your camper’s name clearly labeled. This form requires a parent signature only.

Printable Health Forms

Below are links to download health forms in .pdf format. Descriptions of the forms, including who must submit them, are provided at left.

NEED HELP?

Please call or email the Creative Summer office with any questions you have about camper health forms:
301-365-6003 or creative.summer@holton-arms.edu.