General HistoryWe’d like to know a little more about your medical history Name * First Name Last Name Please list any dietary restrictions, food allergies, or preferences We do have options for vegetarian or gluten-free diets, but we must request them in advance. If you need any special meal accommodations, please list them here and we will contact you to discuss specifics List any other medical challenges Example: other medical diagnoses, allergies, asthma, hay fever, etc) List any drug allergies Please explain your system for giving/taking medications oral, injection, etc If your child has had seizures, please describe the type of seizure If yes, when was the date of the last seizure? Would your child benefit from extra support or supervision while at camp? This may include bahavioral support, mobility support, etc. Please explain Is there any other information that will help us care for your child? Authorization for Oscar the MS Monkey 501(c)(3) to provide medical, dental, and surgical treatment * In the event that I am not available, I give Oscar the MS Monkey staff permission to authorize emergency care and treatment for my child. Notification of the parent will always be attempted. By typing my name below, I am electronically signing (Parent/Guardian) You’re not done yet! Please be sure to fill out ALL of the following:
