1902 Fairfax Ave Cherry Hill NJ 08003

2019 Authorization for Non-Prescription Medication Form

Authorization form for non-prescription over-the-counter skin products

INSTRUCTIONS - This form must be completed by the parent/guardian to authorize the use of: • Sunscreen • Insect Repellent • Diaper Ointment / Cream
  • Please list the names of the products and the known adverse reactions (if any)
  • This authorization is effective for the duration of Camp Connect June 24th - August 30th 2019
  • Date Format: MM slash DD slash YYYY