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Camp Medical Administration Request Form


This form is to be completed for any child that requires medication during camp hours. This personal information and personal health information is being collected, used and disclosed to program staff for the purpose of administering medication.

Medical Alert I.D.:
I authorize the Kawartha Lakes Parks and Recreation staff to (please select appropriate box):

Parent/Guardian Authorization


Personal information contained on this form is collected in pursuant to the Municipal Act, 2001 and will be used for the purpose of responding to your request. Questions about the collection of this information should be directed to the City Clerk or Deputy-Clerk at


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