Attendee Name [First, Last]
What type of unit does the attendee belong to?
Select Pack Troop Crew
What is attendee's Unit number?
Parent/Guardian Phone Number
What is the best phone number to contact attendee's parent/guardian?
Participant Phone Number
What is the best phone number to contact attendee?
Parent/Guardian E-mail Address
What is the best email address to contact attendee's parent/guardian?
Participant E-mail Address
What is the best email address to contact attendee?
Which Summer Camp will you be attending?
Select Camp Cole Canoe Base D-bar-A Scout Ranch Gerber Scout Reservation Camp Munhacke Rota-Kiwan Scout Reservation Camp Rotary Trail to Eagle
Are you a Boy Scout or Cub Scout?
Select Cub Scout Boy Scout
What are the dates of camp you will be attending?
Please describe the type of dietary restriction in detail.
Please select all that apply. Shift+Click to select multiple.
Ingestion Contact Airborn Other
Allergy Type - Other
If you selected "Other" [above] please explain.
What is the severity of the allergy? i.e. anaphylactic
What are the symptoms experienced by participant? i.e. vomiting
Is allergy controlled by medication? Yes/No, if yes, what medication(s) are prescribed?
Medication at Camp
If medication is prescribed, will participant have medication(s) at camp? If yes, what is the prescribed dosage?
What are some substitution ideas?
Is there any other information you can provide that would be useful to our Food Service Staff to ensure for an awesome week at camp?