Koinonia Nature Camp Child Medical Release Form

Thank you for submitting your Nature Camp Registration! The next step is to complete a medical release form for each child registered.

Please complete and submit the below form separately for each child that you have registered for nature camp. This is the only record of medical information we have on your child so it is important that you fill this out honestly and completely. It is for your child’s well-being and safety.

Once this form is submitted, you will receive an email confirming this information plus an attached Health History document for your child. You must sign the attached document and send it back to us, either via email to program@koinoniany.org or via mail to Koinonia Nature Camp, 165 Lakeview Drive Road, Highland Lake, NY 12743.

All signed documents must be received at least one week prior to your child’s first day of camp. Please note that no participant will be accepted into the program until all information is completed, signed, and given to our office.