Richfield, OH · Summit County
Camper Health History Form
Parents or guardians complete this form to share a child’s health history and permissions for Richfield Recreation Center’s Summer Day Camp.
What this form is
The Camper Health History Form provides camp health personnel with information to help care for a child during Richfield Recreation Center’s Summer Day Camp. A parent or guardian fills in the child’s contact and health information, medications, emergency contacts, permissions, and authorized pick-up people, then signs the authorization and waiver sections. The form also requests a sample menu or special food list when applicable.
Who needs it
A parent or guardian of a child attending Richfield Recreation Center’s Summer Day Camp should complete and submit this form.
How to submit it
The form says it may be dropped off at the Village of Richfield Parks & Recreation, 4410 W. Streetsboro Road, Richfield, OH 44286, by June 10, or at camp on the child’s first day.
About notarization
This document is signed without a notary; the parent or guardian signs and dates the form and waiver, with no notarized attachment or related step specified.
How to submit this form
- 1
Download The Form
Download the Camper Health History Form PDF.
- 2
Complete The Form
A parent or guardian fills in the child’s health, contact, medication, and other requested information and signs the applicable sections.
- 3
Gather Any Attachment
If the child requires a doctor-prescribed diet, attach a sample menu or special food list.
- 4
Drop Off The Form
Drop it off at the Parks & Recreation office by June 10, or at camp on the child’s first day.
Frequently asked questions
- Do I need a notary for the Camper Health History Form?
- No. The form is signed and dated by the parent or guardian without a notary; it does not specify a notarized attachment or related step.
- How do I submit the Camper Health History Form?
- The form says to drop it off at the Village of Richfield Parks & Recreation office by June 10, or at camp on the child’s first day.
- What information does the form ask for?
- It asks for the child’s contact and health history, medications, emergency contacts, insurance information, permissions, authorized pick-up people, and parent or guardian signatures.
- Are any attachments mentioned?
- If the child requires a doctor-prescribed diet, the form asks the parent or guardian to attach a sample menu or special food list.