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PARTICIPANT FORM Event Name:Event Date:Participant Info First Name:Last Name:Birthday:Grade in Fall:EpiPen Required:Engender:Allergies or Prescribed Medication:Ethnicity:YesNoEpiPen Requirements:Allergies
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How to fill out epi-pen required

01
Remove the EpiPen from the carrying tube.
02
Hold the pen firmly in your fist with the orange tip pointing downward.
03
Remove the blue safety release by pulling it straight up.
04
Swing and firmly push the orange tip into the middle of the outer thigh.
05
Hold the pen firmly in place for 10 seconds.
06
Remove the EpiPen and massage the injection site for several seconds.
07
Seek immediate medical attention after administering the EpiPen.

Who needs epi-pen required?

01
Individuals with a history of severe allergic reactions.
02
People with known allergies to insect stings or certain foods.
03
Those who have experienced anaphylaxis in the past.
04
Individuals with a medical condition known as mastocytosis.
05
People who have been prescribed an EpiPen by their healthcare provider.
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Epi-pen is required for individuals who have severe allergies and are at risk of anaphylaxis.
Individuals with severe allergies or their caregivers are required to have and administer epi-pens.
Epi-pens are filled out by removing the safety cap and firmly pressing the tip of the pen against the outer thigh.
The purpose of epi-pens is to quickly administer epinephrine in case of a severe allergic reaction.
The expiration date of the epi-pen, any known allergies, and emergency contact information must be reported.
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