After you have filled out the Camp Application , please fill this camper health & info form out as well. Any questions? Don't hesitate to call Malky at 713-398-7124 or email [email protected] Parent & Camper InfoParent filling out this form*First NameLast NameE-mail*Primary emailChild*First NameMiddle NameLast NameAge*Interests, talents, etc.Or anything else you would like the counselor to knowAny Health IssuesAny health issues you would like us to be aware ofHealth & Emergency ContactsIf any health or wellness issue arises, we will contact one of the parents. In case of emergency, or where the parents cannot be reached, please provide doctor, insurance and an additional emergency contact below.Health Insurance Info*Insurance name, type and policy numberPediatrician*Name and contact info for child's doctorEmergency Contact*Name and number for backup contact in case parents cannot be reachedCommentsShould be Empty: Submit This page uses TLS encryption to keep your data secure.