Camp Registration - $190.00


High School Upperclassmen (College Recruitment)


Health History Report

Allergies, Food or Drug

Anxiety (nervous problem)

Asthma

Bone, joint, muscle or other orthopedic problems

Eating Disorder

Emotional or psychiatric problems

Epilepsy or seizures

Fractures (bone)

Hay Fever

Hemophilia (bleeding problem)

Other Blood Disorders

Hospitalization

Mental Illness

Migraine Headaches

Muscle weakness or paralysis

Otis Media (ear infections)

Pneumonia

Shingles (Zoster)

Sight Impairment (Glasses or Contacts)

Stomach or intestinal problems

Surgery

Tendonitis

Thyroid problem

Other

None of the Above

Insurance Information: Please provide specific insurance information. This information is required by the hospital when treating patients.

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