Untitled - Girl Scouts Heart Of Central California

Immunization History
Please attach a copy of your camper’s immunization history or
provide immunization dates on the Camper Health History and
Exam Record. If you wish to request an exemption to the
immunizations please contact the Program Center to request an
Immunization Release Form (#CM 32).
Physical Exam
Girl Scouts of the USA and the American Camp Association
require each camper to have had a physical exam within the
past 24 months. A licensed physician, physician’s assistant or
nurse practitioner can perform the physical. If your child has
had a physical in the last 24 months you do not need to
schedule a special physical just for camp. You can attach the
school or sports physical record or have the doctor fill in the
physician’s statement on the back of the Camper Health History
and Exam Record with the results of the latest physical. We
have forms on file at the Program Center for those campers
who attended camp last summer, if that physical is still current
we can pull the form for you but you will still need to complete
and sign the health history portion of the form so it is current.
Please call the Program Center (916) 452-9181 or (800) 322-
4475 at least two weeks before the camp session if you wish
them to pull your form. If your camper has not had a physical in
the last 24 months try to schedule one at least 4 weeks prior to
their camp session so you can send your paperwork in on time.
Exemption
If you wish to request an exemption to waive the health exam
and/or medical treatment, please contact the Program Center
to obtain a Religious Medical Exemption Form (#CM 33).
Waivers must be signed by a religious official indicating
membership in the religious group named.
Camper and Parent Letter to Counselors (CM 21 and CM 31)
The letters from the parent and camper will help camp staff to
“get acquainted” with each camper prior to camp. This
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