Allergy Action Plan

This information is used in case of emergency and accessible to all our staff during your child’s week attending camp. Having a plan in place will ensure all parties will feel safe and secure. If you need to reach out via email for any questions or further explanation, contact us.

Campers Name

First Name

Last Name

Date of birth

MM

DD

YYYY

Contact Name

This will be the first call made in case of emergency.

First Name

Last Name

Contact Phone #

(###)

###

####

Doctors Name

First Name

Last Name

Doctors Phone #

(###)

###

####

Health Card #

Does your child require a Epi Pen to be carried during camp?

Yes

No

Please describe the allergen(s) your child has and the severity level of it.

Action Guide

Type your preferred allergen action plan for your child's allergy. Specify as to where and what the symptoms may be (mouth, eyes, skin, lungs etc.)

Please note: all children who can an Epi Pen receive a 911 call and Epi Pen is administered when reaction occurs.