Camp Oh Ah Lay Lay Program Aide

Medication Form

Program Aide's Name

First Name

Last Name

Parent/Caregiver's Name

First Name

Last Name

Parent/Caregiver's Email

Daily medication

My Program Aide takes medication daily. Yes/No. This includes ANY medication that your PA takes, prescription or not. ANY medication, regardless of time of day it is taken.

Yes

Permission

My camper has permission to administer their own medication while attending an overnight Camp Oh Ah Lay Lay event as a Program Aide.

Yes

If you answered "YES" to allowing your Program Aide to administer their own medication at an overnight Camp Oh Ah Lay Lay event as a Program Aide, please type your name below. By typing your name below you are agreeing that your program aide is responsible for their own medication and therefore releasing all responsibility and liability from Camp Oh Ah Lay Lay, it's volunteer leaders and Girl Scouts of Western Washington

If your PA takes daily medication and you answered "NO" above to allowing your PA to administer their own medication at an overnight Camp Oh Ah Lay Lay event as a Program Aide, please list medications below and time to be administered.

Signature

I am the legal parent/caregiver of the Camp Oh Ah Lay Lay program aide mentioned above and by typing my full name below I hereby agree that the information on this form is true and factual.

Camp Oh Ah Lay Lay Program Aide

Medication Form

Camp Dates:

Camp Oh Ah Lay Lay Location:

Registration opens February 1, 2025