The mission of KSI is to create opportunities for individuals with disabilities
to learn and grow. Through training, education and supportive programs and services, we
enable individuals to accomplish their personal and work-related goals.
DONATE Now
About KSI
Our Programs
Families & Providers
Business Services
Cartridge Services
Kamp Lenape Permission for Over-the-Counter Medications
{}
W10=
*
Camper First Name
*
Camper Last Name
*
Does your child have any allergies to medication?
Yes
No
If YES, please list medication allergies
As a parent/guardian, I give my permission for the above named Camper to have the following medications administered by the Kamp Nurse. I understand that he/she will be checked by the Kamp Nurse, and the medications will be administered if indicated following the Nurse’s assessment. Please check only those medications you wish to be given to your child when needed.
Select all that apply
Advil/Ibuprofen/Motrin
Anti-Fungal Cream
Benadryl
Caladryl/Calamine Lotion
Cough Drops
Eye Wash Solution/Saline Rinse
Hygiene Supplies
Lip Ointment (Blistex/Chapstick)
Skin Ointment (Bacitracin/Hydrocortisone/Neosporin)
Sting Kill (Insect Sting Relief)
Throat Spray (Chloraseptic Spray)
Tums
Anbesol/Orajel
Burn Ointment/Spray
*
Signature of Parent/Guardian (Type Full Name)
Submit
Submit Bid
/frontend_forms/resumable_upload/
X
Confirm
Cancel
