YEAR 7 CAMP – Medical Form

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YEAR 7 CAMP - Medical Form 2025

This report is intended to assist the School in the case of any medical emergency with your child. All information is held in confidence. This report is kept on file. A copy may accompany the student if transport to a hospital or a local medical practice is required.

Student Name*
First Last
Student Date of Birth*
DD slash MM slash YYYY
Gender*
- Male
- Female
Is your child a confident swimmer
Medical Information
Does your child have any of the following medical conditions:*
- ANAPHYLAXIS (or risk of) - If yes, Anaphylaxis Action Plan mus be supplied to the school. The student must bring TWO in date epi-pens. Staff will carry an additional epi-pen. students must carry TWO epi-pens on them at all times.
- ALLERGY (or risk of) - If yes, Allergy Action Plan must be supplied to the school.
- ASTHMA (or risk of). If yes, Asthma Action Plan must be supplied to School. All students must carry their own Asthma reliever medication, including spacer if required.
- DIABETES - If yes, a Diabetes Management Plan must be supplied to the School.
- Epilepsy or seizures (or risk of)
- Travel Sickness
- Migraine/headache
- Chronic health condition, please specify below:
- Other, please specify below:
- No
Please Specify:
Action Plans
Max. file size: 512 MB.
Please upload any relevant supporting documents for the choices selected above, if they are applicable.
Does your child have a hearing or vision impairment:*
- Yes, Please specify:
- No
If Yes, Please Specify:
Does your child have a physical disability or mobility issues:*
- Yes, Please specify:
- No
If Yes, Please Specify:
Does your child have a National Disability Insurance Scheme (NDIS) plan:*
- Yes, Please specify:
- No
If Yes, Please Specify:
Have you provided AGS with specialist medical reports or letters:*
- Yes, Please specify:
- No
If Yes, Please Specify:
Medication Administration on Camp
Does your child require medication while at school?*
- Yes, complete the Medical Administration Form linked on the front page.
- No
Do you consent to the following medications being administered on camp if required?
Paracetamol (e.g. Panadol):*
- Yes
- No
Ibuprofen (e.g. Nurofen):*
- Yes
- No
Antihistamine (e.g. Claratyne, Zyrtec, Telfast):*
- Yes
- No
Salbutamol (e.g. Ventolin):*
- Yes
- No
Antiseptic Cream*
- Yes
- No
Throat Lozenge*
- Yes
- No
Consent*
I agree to the following statement
I authorise the School to consent where it is impractical to communicate with me, for my child to receive medical or surgical treatment as may be deemed necessary. I also authorise the School to arrange for an ambulance to transport my child to hospital in the case of a serious injury or illness. I also agree I will meet the cost of such a service.

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