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CAMP INFORMATION Youth Camp Name YMCA CAMP LETTS Camp Address 4003 Camp Letts Road Edgewater MD 21037 III. Result 0 Positive 0 Negative Vaccine DPT TD Tetanus/diphtheria Tetanus Polio MMR Mo/Yr. or Mumps or Rubella Haemophilus Influenza B Varicella Health Care Recommendations by Licensed Physician Proof of Physical Exam I examined this individual on DATE ACA accreditation requirements specify exams within 24 months of camp attendance. Country in which camper resides OR Attach Department form...
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