Health Form

WCFA Health & Emergency Contact Form

Camper families must complete this form prior to the first day of camp.

Student/Camper Information

Childs Name(Required)
At time of first day of camp/class
ex: she/her. they/them, he/him, etc.
We ask for this optional information in order to provide data for our funding/grant applications.
Additional Participant Information:
Medications
Please also use this space to explain any other physical, mental, emotional or social health situations that staff should be aware of to ensure this child has the best possible experience at camp/class.
ex: 5 Maple Lane, Warwick, RI 02886
Parent or Guardian's Email(Required)
Pick Up Authorization
ex: Cedar Hill Elementary, Warwick
Would you like to sign up for our monthly email newsletter?