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You can complete
the form by:

  1. Submitting the online form
  2. Download/Print/Fax the form below
MedicalForm12.pdf
File Size: 71 kb
File Type: pdf
Download File

This form must be completed for EACH CHILD and submitted prior to June 1st, 2012.  It DOES NOT need to be filled out by a physician, BUT if the camper is 6 years of age or less, Dade County requires that you provide us a physician-signed copy of a current (within 12 months of 5/29/12) HRS Form 3040 (Cert of Good Health) and HRS Form 680 (Cert. of Immunization).

    Health and Emergency Contact For Campers

    IMMUNIZATION RECORDS - Please provide approximate dates (MM/DD/YY) for each.
    MEDICAL INFORMATION - Type "NA" if no conditions present for each.
    RELEASE: This statement must be agreed to in order for your child to attend camp:

    "This health history is correct so far as I know, and the person herein described has permission to engage in all prescribed activities as noted.  AUTHORIZATION FOR TREATMENT: I hereby give my permission to the medical personnel selected by the camp director to: order X-rays, treatments, and release of any records necessary for insurance purposes, and to provide or arrange any transportation for my child (camper) in the event I cannot be reached in an emergency.  I hereby give my permission to the physician selected by the camp director to secure and administer treatment including hospitalization for the above named child (camper).
Submit
FUNCAMPS, Magic Camp -Miami Summer Camps,Coral Gables Summer Camps,-Boca Raton Summer Camps - University of Miami  - 
(C) 2022 Funcamps - Ph: 305-666-2992
  • Home
  • Programs
    • MagiCamp
    • Amazing Science & Space Camp
    • JurassiCamp
    • Gametech Institute
    • Gametech: Robotics Camp
    • FunArts
  • About
    • Our Story
    • FAQ
    • A Typical Day
    • Accreditation/ Press
    • Brochure & More Info
  • Locations
    • Miami / Dade >
      • University of Miami (Coral Gables)
      • Pinecrest Summer Camp
    • Boca Raton >
      • Boca Raton (FAU)
  • Photos
  • Contact Us
    • Contact
    • Job Apply (counselor/staff)
  • ENROLL NOW!
    • Dates & Tuition
  • Dates & Tuition