Camp Medical Release / Authorization Form

"*" indicates required fields

Gymnast / Camper Information

MM slash DD slash YYYY

Contact Information

Please provide a list of approved people to pick up the gymnast/camper.*
Anyone not on this list will not be allowed to take the gymnast/camper with them without previous confirmation provided to Olympiad Gymnastics from their legal guardian OR if the person not on this list provides a 4-Digit PIN to identify themselves as an approved person.
In the circumstance in which an approved person cannot pick up their gymnast/camper this 4 Digit PIN can be provided by the person to the Olympiad Gymnastics Staff that is attempting to pick up the gymnast/camper.

Primary Emergency Contact Information

In Case of Emergency, Please Contact:

Secondary Emergency Contact Information


Doctor Information

Doctor's Name

Medical Information

If it is necessary for your child to receive medication during the camp day, please do the following: 1. Send the medication to camp with a responsible individual (if you are unable to bring it) and give it to the camp coordinator. 2. Send the medication in the original container, properly labeled with the original pharmacy dosage information.

Release & Policies