2019 Cathedral of the Pines Health Form

For Campers, Counselors, Workstaff, Cooks, Health Professionals, and Staff Members

This form must be completed by a parent or guardian and the camper, counselor, workstaff or the adult participant.

You or your child cannot attend camp unless the form is completed and on file at Mount Olivet Lutheran Church.

You will need the following items to complete this form:
 - Insurance Information (policy number, address, phone number)
 - Clinic/Dr. Information/Phone number
 - Tetanus Shot Date
Once you have all of the above requested information and are ready to fill out your health form, click NEXT on the button below.
I need to complete a health form for... *
Please select camping session *
Please select all that apply from the list below: *
This form is for: (check all that apply) *