FCC Rodeo Bible Camp
HEALTH CARD

please print

Name____________________________________Age______Sex_______

Address_____________________________________Phone____________

City__________________________State____________Zip_____________

Parent’s name or lawful guardian:__________________________________

Two phone #’s in case of emergency________________________________

Friend or relative____________________________Phone______________

Insurance company______________________________________________
    Policy #_________________________ Phone___________________


Please use the back of this card to list the following:  medications currently being taken by the camper, allergies, or any special precautions to be taken at camp.

INSURANCE CARD PHOTOCOPY ( BOTH SIDES)