Staff Medical Form 2026

*Denotes Required Field

Please complete and submit this Medical Form along with your Staff Application Form

* Full Name

* BC Health # or equivalent

* Birthdate

MEDICAL HISTORY

Check if any of the following apply:

Allergies

Dietary

Significant injuries/illnesses

Please provide details for above selection, prescriptions currently being taken, and note if any limitation may affect camp: Medications must be in the original container. Prescriptions may only be used by the person for whom they are prescribed.

Our First Aid room stocks the four commonly accepted medications: Tylenol, Advil, Benadryl and Gravol – or their generic equivalent. Please list any of these meds to which you oppose being given.

AUTHORIZATION

I recognize that, while BWWA will care for me/my child in a responsible manner, accidents and discomforts may still occur. I’m fully aware of the types of activities I/my child may be involved in, and I accept that these activities often come with a degree of spontaneity and risk. Should injury require emergency treatment I authorize the Director or First Aid Attendant to treat the injury as needed.
I will provide BWWA with “need-to-know” information to assist them to care for the well-being of me/my child.

* Applicant Signature Use your mouse or finger to sign here

* Date of Signature

Parent/Guardian Signature (If under 19 years of age must be signed by a parent/guardian) Use your mouse or finger to sign here

Date of Signature

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