Each child who comes to camp, receives 1 free t-shirt. (Please choose one)

Please list the any of the following conditions your child has or has had in the past in the form to the right:

• Kidney Trouble

• Heart Trouble

• Lung Trouble

• Sinusitis

• Bronchitis

• Asthma

• Diabetes

• Sleepwalking

• Mononucleosis

• False Teeth

• A frequent Sore Throat

• Frequent Ear Infections

• Bleeding/Clotting Disorders

• Convulsive Disorders

In case of emergency or illness, I hereby give permission to the physician selected by WWAC camp directors to secure proper treatment, hospitalize, and to order injection, anesthesia or surgery for my child

Thanks for submitting!