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 Posted: Sat Nov 25, 2006 3:10 pm
*Chews on a Dismembered Leg* Yummy in my Tummy
Cloud:....Upset Who O_o; My sisters just in a bad mood
Terra:Why we're you glareing at me -_-;
Vera:*Squats by Soren and Reyn*
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Posted: Sat Nov 25, 2006 3:12 pm
Maliki- *snorts and walks off to find Ketsuki*
Demon- *raises up* no one said you were upset
Soren- *nuzzles Vera gently*
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Posted: Sat Nov 25, 2006 3:20 pm
Reyn:Where'd Hawk go?
Vera:*Snuggles Soren*
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Posted: Sat Nov 25, 2006 3:25 pm
Suicide: *shrugs* I dont know
Soren- *laughs gently at Vera* hey
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Posted: Sat Nov 25, 2006 3:29 pm
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Posted: Sat Nov 25, 2006 3:38 pm
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Posted: Fri Jul 13, 2007 4:38 pm
2007 Medical History Form & Release
NAME:
AGE:
ADDRESS:
In Case of Emergency Notify:
Phone:
Family Physician Phone:
Family Insurance Co. Policy #:
IMMUNIZATIONS:
Tetanus [ ]
Polio [ ]
Booster [ ]
Measles [ ]
Mumps [ ]
Other[ ]
PAST MEDICAL HISTORY"
(Check giving appropriate information)
Asthma [ ]
Sinusitis [ ]
Bronchitis [ ]
Kidney Trouble [ ]
Heart Trouble [ ]
Diabetes [ ]
Dizziness [ ]
Digestive Trouble [ ]
Hay Fever [ ]
Other [ ]
ALLERGIES: (List type)
Food [ ]
Penicillin or other drug (Name) [ ]
Insect stings/bites [ ]
Poison sumac, oak, or ivy [ ]
Previous operations or serious illness:
Any current medications: (List)
Special Diet: (Name)
Childhood Diseases:
Chickenpox [ ]
Measles [ ]
Mumps [ ]
Whooping Cough [ ]
Other [ ]
PERMISSION FOR TREATMENT AND DISCHARGE
My permission is granted for Camp Rhapsody/Rhapsody Performing Arts staff member to obtain necessary
medical attention in case of sickness or injury for (Participant's
Name). I/We, the undersigned, do hereby release, and forever discharge all sponsors and Rhapsody Performing
Arts from any and all claims, demands, actions or cause of action, past, present, or future arising out of any
damage or injury while participating in the event. We further accept financial and physical responsibility for the
return of our child(ren), should the adult supervision find it necessary to send him/her/them home (as
applicable).
Signature of Parent/Guardian Date
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