MEDICATION CONSENT FORM
Please note: the medication administration authorization form (separate form) must be filled out and properly signed if you send medication to camp with your child. Medication means both prescription and non-prescription. All medications must be in the original container, and require a PHYSICIAN’S SIGNATURE. A PARENT/GUARDIAN signature is also required.
I hereby authorize and request the camp nurse at McDaniel College Summer Music Camp to administer the medication(s) listed to my child______________________.
(Camper’s Name)
Provided the medication is administered as instructed on the authorization form and without negligence, I release and indemnify the camp nurse and all persons associated with the camp from any liability for administration of the medication.
___________________________
Signature of Parent or Guardian
PARENT PROCEDURES FOR MEDICATIONS:
1. Have the medication authorization form (separate form) properly filled out and signed.
2. Bring to Registration—do not mail it back.
3. Medications MUST be in the original container(s) marked specifically for the camper.
4. Put container(s) in a paper bag marked with the camper’s name.
5. Send only the amount of medication needed for the days of camp.
(Example: One tablet every day x 6 days of camp = 6 tablets).
Send ONLY the amount needed. Empty bottles will be returned.
6. Give bag of medication(s) and Medication Consent Form(s) to nurse at registration.
Campers may keep certain maintenance medications locked in their suitcases if they have BOTH a parent and physician signed authorization form (reverse side of this form). Such medications may include:
Multivitamins
Asthma inhalers
Maintenance acne medications (oral/topical)
Oral contraceptives
Epi Pen Auto injector
Only enough medication for the week should be brought to camp, and kept locked in a suitcase. All other medications will be kept by the camp nurse. Medications not on the approved list, brought to camp, will be at the discretion of the camp nurse on whether the medication is kept with the camper. Disregard of these policies could result in camp dismissal.
Note: each medication requires a separate order. Duplicate this form as needed.