Additional Behavioral Support Form
THIS FORM MUST BE SUBMITTED AS PART OF THE APPLICATION IF: Applicant has a behavioral, emotional ,or mental health diagnosis (e.g., ADD/ADHD, Anxiety, Depression, OCD), has seen a mental health professional (e.g., social worker, psychologist, psychiatrist) in the past 12 months, has been prescribed or is currently taking a mood-altering medication for any reason AND additional information has been requested by JA Camp mental health director. THIS FORM MUST BE COMPLETED BY: (1)The mental health professional (social worker, psychologist, psychiatrist, etc.)currently overseeing the applicant’s care, if applicable, OR; (2)The medical professional that prescribed the medication or diagnosed the behavioral, emotional, or mental health condition.

Additional Medical Diagnosis
THIS FORM MUST BE SUBMITTED AS PART OF THE APPLICATION IF: Applicant has a diagnosis in addition to their childhood rheumatic disease diagnosis AND additional information has been requested by JA Camp medical director. THIS FORM MUST BE SUBMITTED ALL APPLICANTS AND COMPLETED BY: (1)The medical professional that manages additional diagnosis.

Camper Media and Photography Release
Please review and sign.

Family Camp Media and Photography Release
Please review and sign.

Volunteer Agreements, Waiver, and Release
Includes risks and liability waiver, participation expectation, and transportation consent

Volunteer Media and Photography Release
Please review and sign.

Camper Physician Medical Form

Once completed, please submit this form using one of the following options:

1. Upload the form to the Document Center in UltraCamp.
2. Fax the form to (888) 755-7365. When faxing, this cover page must be included.
3. Scan the documents, including this cover sheet, and save as a single PDF file. Then email the file as an attachment to: forms@submitMyForms.com