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List any physical limitations 4. List any ALLERGIES to foods drugs bee/wasp stings etc. 5. Does your child wet the bed Sleep Walk 6. List any recent injury illness or infectious disease that may affect child s participation 2. List any chronic/recurring illness or disease 3. This form must be signed by BOTH a parent and the physician. List any food restrictions PAGE 1 OF 2 GENERAL HEALTH QUESTIONS 1. In an emergency if camp personnel are unable to contact me I hereby give permission to the...
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10160 South M-37 Highway is the address of a location or property.
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