Medical Forms

All required forms should either be scanned and emailed to or please print out and mail the forms back to the Camp prior to the Camper’s first day of Camp.

Physical Form: Mandated by the state, a Physical form must be completed and mailed, scanned/emailed or faxed (203-322-0406) to the camp prior to your child’s first day. Medical forms are valid for 3 years from date of examination.  

Permission to Administer: If your child requires medication to be administered by the camp nurse, you must complete an Administration of Medication form. The nurse cannot accept medications without this form being completed. Your doctor's signature is required on this form. All medications must be in their original box containers.

Individual Care Plans (ICP): An Individual Care Plan is required and necessary when a child has a special health care need or disability and it is necessary that special care be taken or provided while the child is at camp. Together with the nurse, the specific care plan will be documented and signed by you (parent or guardian), and counselors in your child’s group.

Generic Individual Care Plans (ex. bee or food allergies, asthma, etc.) are available below. A blank form for plans that require more customization is also provided.

Individual Care Plan - Food Allergy

Individual Care Plan - Bee Allergy

Individual Care Plan - Asthma

Individual Care Plan - Custom

Health History Survey (Online ): In addition, we strongly encourage that each camper have a completed Health History Survey before your child’s first day. This will provide us with pertinent information that will ensure a safe experience at LRC. Information on how to provide this is included in the Camp Handbook and this survey can be completed after your child is registered for the upcoming Camp season.