Westside Summer Camp Health Form

Required

Effective January 21, 2022, Westside School is requiring that all students/campers ages 5+ be fully vaccinated against COVID-19, and all teachers/staff be vaccinated and boosted.
 
Please upload your child's COVID-19 vaccination card (image or scan) and certificate of immunization record (CIS).
 
Additionally, please list relevant medication, allergy, and medical information below.  
Parent/Guardian Namerequired
First Name
Last Name
Parent/Guardian Email Addressrequired
Student Namerequired
First Name
Last Name (optional)
Medications
Allergies
Additional Relevant Heath Information
Proof of COVID-19 Vaccinationrequired
Attach up to 3 files with a maximum size of 10MB
No file chosen
Certificate of Immunization Record (CIS)required
Attach up to 3 files with a maximum size of 10MB
No file chosen