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Kieve-Wavus Education, Inc. CAMPER HEALTH HISTORY FORM 1 Please Print All Information Dates will attend camp: / / Month Mail this form to c/o Marge Greenleaf Kieve-Wavus Education, Inc. P.O. Box 350.

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How to fill out the Medical Form 1 - Camp Kieve - Kieve online

Filling out the Medical Form 1 for Camp Kieve is a critical step in ensuring your camper's health and safety during their stay. This guide provides clear instructions to help you complete the form online with ease and confidence.

Follow the steps to fill out Medical Form 1 accurately.

  1. Press the ‘Get Form’ button to access the Medical Form 1 and open it in the online editor.
  2. Enter the dates your camper will attend camp. Include the month, day, and year in the designated fields.
  3. Provide the camper's name by entering their first, middle, and last name in the appropriate sections.
  4. Fill in the camper's birth date and age on arrival at camp.
  5. Complete the social security number section. Ensure accuracy for proper identification.
  6. Input the camper's home address including street, city, state, and zip code.
  7. List the parent or guardian with legal custody, including their name, relationship to the camper, preferred contact method, phone numbers, and email address.
  8. Include the second parent or guardian or another emergency contact’s information.
  9. Detail any allergies the camper may have, including food, medicine, or environmental allergies. Indicate if they have no known allergies.
  10. Fill out the medical insurance information. Attach a copy of the insurance card if required, making sure both sides are readable.
  11. Complete the primary care physician's name and any other relevant health care provider information.
  12. Carefully review the general health history questions and check 'Yes' or 'No' for each statement, providing explanations for any 'Yes' answers.
  13. Address mental, emotional, and social health queries in the same manner as the general health section.
  14. Provide any additional health information that may impact the camper's participation.
  15. Sign and date the form, ensuring all information is accurate. If you cannot sign for religious reasons, contact the camp for a legal waiver.
  16. Save your changes, download a copy for your records, and be ready to print or share the form as needed.

Begin filling out the Medical Form 1 for Camp Kieve online today to ensure a safe and fun experience for your camper!

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Wavus (wă-vus) A revered Native American chief who, with his people, inhabited the Point on Damariscotta Lake long ago.

RESIDENTIAL. The cost to your school is $42.50 per day for each student and $85 per day for each faculty or staff participant, who will each receive a copy of our curriculum resource, Kindness and Respect. Our model, 5-day Residential program is $212.50 per student and $425 per faculty or staff.

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