• 2025 RFK Camper Application

    2025 RFK Camper Application

    Manhattan, Kansas Camp Dates : Monday June 9 to Friday 13, 2025
  •  - -

  •  -
  •  -
  •  -
  •  -
  •  -

  • CAMPER DETAIL

  •  
  •  

  • HEALTH HISTORY

    Indicate all known allergies, illness, disabilities, physical limitations or medical complications:




  • PRESCRIPTION MEDICATIONS

    All medication sent to camp must be in original labeled container with the pharmacy label on it.

  •  -
  • 0/1000
  • MEDICAL RELEASE

    I understand that it is my responsibility as caregiver to make sure that all instructions are clear and that the necessary dosage is adequately supplied for the duration of camp. I hereby authorize Royal Family KIDS of Manhattan, KS Camp Nurse to administer the above medication from June 9 thru June 13, 2025.

    This health history is correct so far as I know, and the above named minor has permission to engage in all prescribed program activities, except as noted. The undersigned do hereby authorize the directors of Royal Family KIDS of Manhattan, KS Camp, or such substitute as they may designate, as agent for the undersigned to consent to an X-Ray examination, anesthetic, medical, dental or surgical diagnosis or treatment and hospital care for the above minor which is deemed advisable by and to be rendered under the general or special supervision of any physician and surgeon, licensed under the provision of the Medicine Practice Act or any dentist licensed under the Dental Practice Act, whether such diagnosis or treatment is rendered at the office of said physician or dentist, at a hospital, camp or elsewhere. This authorization will remain effective while the above minor is enroute to and from or involved or participating in any camp program, unless revoked in writing by the undersigned and delivered to the Director of Royal Family KIDS of Manhattan, KS as legal guardian/social worker/other. I give my permission for the child to attend Royal Family KIDS of Manhattan, KS Camp during camp through Manhattan First Assembly of God.

  • PERMISSION TO ADMINISTER OVER-THE-COUNTER MEDICATIONS

    I hereby give the Royal Family KIDS of Manhattan KS Camp Nurse permission to administer the following products according to manufacturer’s instructions, or as otherwise specified during the period of camp beginning June 9 and ending June 13, 2025.

    I trust the RFK Camp Nurse to use her best judgment as situations arise, and if in doubt, he/she can call for verification.

    Please check YES or NO for the medications listed below. This form must be completely filled out by the primary caregiver who signs below, or camper may not attend camp.

  •  
  • This is the end of the Camp Application. We have a limit of 16 girls and 16 boys. We will contact you with your status soon. At that time, we will provide specific drop off and pick up times, along with a list of things to pack.

     

  • I certify that I have read, understand, and agree to the provisions of this Activities and Transportation Permission and Release Form, including the separate Medical Release Form included in this application.

  • Thank you so much for your application to Royal Family KID'S Camp  - Manhattan, KS

     

  • Should be Empty: