2022 Health Questionnaire

Please complete this health questionnaire. After you complete the form and hit submit you will be redirected to a page to sign the form.

Health Questionnaire
This person should not be someone attending camp with you.

Health Questionnaire

Parent or legal guardian should complete form for all children under 18 years participating in AMC program.
Unvaccinated participants are required to submit a negative PCR test before transport to camp.

PLEASE READ CAREFULLY

Participants (or parents/guardians, if appropriate) must read and sign below.
Participant acknowledgement of accuracy and understanding. By signing this form, I am declaring that, to the best of my knowledge, I have completed the questionnaire accurately. I also understand that by knowingly filling out the form inaccurately, or by withholding pertinent information about my health, I could potentially be increasing the risk to myself or others.
Consent to accept aid. By signing this form, I am giving consent and permission for AMC staff, volunteers, representatives, or contractors to provide medical care to me or to my child, to transport me or my child to a medical facility or to seek the aid of emergency medical services as deemed appropriate. I further authorize AMC staff, volunteers, representatives, or contractors to render whatever treatment they consider necessary for my or my child’s health, and I agree to pay all costs associated with that care and transportation.After pressing SUBMIT you will be redirected to a webpage to sign this Health Questionnaire. A copy will then be emailed to you for your records.