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Summer at Madeira Required Forms

All campers must submit the appropriate health and medication forms prior to their arrival at camp. All forms are due to the camp office by June 1, 2019. All camper forms and forms from doctors offices must be submitted to the Madeira health team in English. At this time we are unable to accept forms in any other language.  

All documents should be uploaded through the online Registration Portal. Some programs may have additional form requirements.

For Returning Campers:

  • If you have previously submitted camper health forms to Summer at Maderia, no new health forms are needed UNLESS:
    • The actual physical examination was completed by your childs physician before 2017. Physical examinations completed in 2017, 2018, and 2019 are accepted for the Summer of 2019. 
    • Your camper is a rising 7th grader for the fall of 2019. All rising 7th graders must submit a new immunization record.
  • You can contact the camp team at any time if you have questions about camper health forms. 

Camp Greenway

Health Form

Download the Health Form

  • All campers must have a completed Virginia School Entrance Health Form, or the equivalent form for their state of residence, on file prior to the start of camp. 
  • If you have previously submitted camper health forms to Summer at Maderia, no new health forms are needed UNLESS:
    • The actual physical examination was completed by your childs physician before 2017. Physical examinations completed in 2017, 2018, and 2019 are accepted for the Summer of 2019. 
    • Your camper is a rising 7th grader for the fall of 2019. All rising 7th graders must submit a new immunization record.
  • The camp health form includes three parts:

1. The Health Information Form, signed by the parent

2. An Immunization Record, signed by the doctor

3. A Physical Examination Record, signed by the doctor

  • For New Campers:
    • Immunization Records must be up-to-date and Physical Examination Records must have been completed after June 1, 2018.
  • For Returning Campers:
    • For campers entering 7th grade in Fall 2019, we require an updated Immunization Record.
    • Campers physical examinations on file must be dated 2017, 2018, or 2019. Examinations dated earlier will not carry over to 2019.  
    • If your childs health history has changed since you last submitted health forms to Summer at Madeira, please send an updated copy of his/her forms. 

Completed Health Forms must be submitted by June 1, 2019.

Health Forms that are not fully completed will not be accepted. Summer at Madeira reserves the right to withdraw registration for campers whose forms have not been received by June 1, 2019. 

Medication & Allergies

If your child has been prescribed medication he/she will need to bring onto the Madeira campus, you must:

1. Complete an Emergency Care Plan for all EpiPens

2. Complete an Asthma Action Plan for all Inhalers

3. Complete a Medication Consent Form for all other medications

All prescription medications must come to camp in their original pharmacy container, with the prescribing label attached. Please make sure your medication has not expired, as it will not be accepted.

The Madeira Health and Wellness Center is stocked with over-the-counter medications; therefore campers should NOT bring medications such as Acetaminophen (e.g. Tylenol), Ibuprofen (e.g. Advil), Diphenhydramine (e.g. Benadryl), Antibiotic Ointment (e.g. Neosporin), and TUMS if taken as needed to camp. The Health Center will contact the parents/guardian directly to obtain permission to dispense over-the-counter medications to the camper if necessary.

No camper may carry, keep, or dispense for herself/himself or any other camper any prescription or over-the-counter medications. 

Non-compliance with this policy may result in dismissal from camp.

Girls First

Health Form

Download the Health Form

  • All campers must have a completed Virginia School Entrance Health Form, or the equivalent form for their state of residence, on file prior to the start of camp. 
  • The camp health form includes three parts:

1. The Health Information Form, signed by the parent

2. An Immunization Record, signed by the doctor

3. A Physical Examination Record, signed by the doctor

  • Immunization Records must be up-to-date and Physical Examination Records must have been completed after June 1, 2018.
  • International campers must meet Virginia immunization requirements in order to participate in Girls First. If campers arrive who are underimmunized, the Madeira health team will take them to recieve these immunizations. Parents assume all cost associated with immunizing international campers. For more information on require immunizations for international campers, email summer@madeira.org

Completed Health Forms must be submitted by June 1, 2019.

Health Forms that are not fully completed will not be accepted. Summer at Madeira reserves the right to withdraw registration for campers whose forms have not been received by June 1, 2019. 

Health Insurance Card
  • All campers must submit a copy of both sides of their Health Insurance Card, including international campers. 
Calleva Waiver

Download the waiver

  • Girls will participate in on-site team building activities on our outdoor adventure course during their time at GirlsFirst. These activities are facilitated by the trained staff at Calleva Outdoors, a Madeira partner. 
Medication & Allergies
  • If your daughter will be taking medication while at camp (prescription medications, over the counter medications, and/or vitamins) you must complete the Medication Consent Form including the physician signature. 
  • Prescription medication must be in original packaging labeled by the pharmacy with the campers name, dosage, and expiration date. 
  • Non-prescription medication, medication must be in original manufactures container, labeled with the dosage instructions and expiration date and must be included on the Medication Consent Form

Girls First Junior

Health Form

Download the Health Form

  • All campers must have a completed Virginia School Entrance Health Form, or the equivalent form for their state of residence, on file prior to the start of camp. 
  • If you have previously submitted camper health forms to Summer at Maderia, no new health forms are needed UNLESS:
    • The actual physical examination was completed by your childs physician before 2017. Physical examinations completed in 2017, 2018, and 2019 are accepted for the Summer of 2019. 
    • Your camper is a rising 7th grader for the fall of 2019. All rising 7th graders must submit a new immunization record.
  • The camp health form includes three parts:

1. The Health Information Form, signed by the parent

2. An Immunization Record, signed by the doctor

3. A Physical Examination Record, signed by the doctor

  • For New Campers:
    • Immunization Records must be up-to-date and Physical Examination Records must have been completed after June 1, 2018.
  • For Returning Campers:
    • For campers entering 7th grade in Fall 2019, we require an updated Immunization Record.
    • Campers physical examinations on file must be dated 2017, 2018, or 2019. Examinations dated earlier will not carry over to 2019.  
    • If your childs health history has changed since you last submitted health forms to Summer at Madeira, please send an updated copy of his/her forms. 

Completed Health Forms must be submitted by June 1, 2019.

Health Forms that are not fully completed will not be accepted. Summer at Madeira reserves the right to withdraw registration for campers whose forms have not been received by June 1, 2019. 

Medication & Allergies

If your child has been prescribed medication she will need to bring onto the Madeira campus, you must:

1. Complete an Emergency Care Plan for all EpiPens

2. Complete an Asthma Action Plan for all Inhalers

3. Complete a Medication Consent Form for all other medications

All prescription medications must come to camp in their original pharmacy container, with the prescribing label attached. Please make sure your medication has not expired, as it will not be accepted.

The Madeira Health and Wellness Center is stocked with over-the-counter medications; therefore campers should NOT bring medications such as Acetaminophen (e.g. Tylenol), Ibuprofen (e.g. Advil), Diphenhydramine (e.g. Benadryl), Antibiotic Ointment (e.g. Neosporin), and TUMS if taken as needed to camp. The Health Center will contact the parents/guardian directly to obtain permission to dispense over-the-counter medications to the camper if necessary.

No camper may carry, keep, or dispense for herself/himself or any other camper any prescription or over-the-counter medications. 

Non-compliance with this policy may result in dismissal from camp.

Riding Workshop

Health Form

Download the Health Form

  • All campers must have a completed Virginia School Entrance Health Form, or the equivalent form for their state of residence, on file prior to the start of camp. 
  • If you have previously submitted camper health forms to Summer at Maderia, no new health forms are needed UNLESS:
    • The actual physical examination was completed by your childs physician before 2017. Physical examinations completed in 2017, 2018, and 2019 are accepted for the Summer of 2019. 
    • Your camper is a rising 7th grader for the fall of 2019. All rising 7th graders must submit a new immunization record.
  • The camp health form includes three parts:

1. The Health Information Form, signed by the parent

2. An Immunization Record, signed by the doctor

3. A Physical Examination Record, signed by the doctor

  • For New Campers:
    • Immunization Records must be up-to-date and Physical Examination Records must have been completed after June 1, 2018.
  • For Returning Campers:
    • For campers entering 7th grade in Fall 2019, we require an updated Immunization Record.
    • Campers physical examinations on file must be dated 2017, 2018, or 2019. Examinations dated earlier will not carry over to 2019.  
    • If your childs health history has changed since you last submitted health forms to Summer at Madeira, please send an updated copy of his/her forms. 

Completed Health Forms must be submitted by June 1, 2019.

Health Forms that are not fully completed will not be accepted. Summer at Madeira reserves the right to withdraw registration for campers whose forms have not been received by June 1, 2019. 

Medication & Allergies

If your child has been prescribed medication he/she will need to bring onto the Madeira campus, you must:

1. Complete an Emergency Care Plan for all EpiPens

2. Complete an Asthma Action Plan for all Inhalers

3. Complete a Medication Consent Form for all other medications

All prescription medications must come to camp in their original pharmacy container, with the prescribing label attached. Please make sure your medication has not expired, as it will not be accepted.

The Madeira Health and Wellness Center is stocked with over-the-counter medications; therefore campers should NOT bring medications such as Acetaminophen (e.g. Tylenol), Ibuprofen (e.g. Advil), Diphenhydramine (e.g. Benadryl), Antibiotic Ointment (e.g. Neosporin), and TUMS if taken as needed to camp. The Health Center will contact the parents/guardian directly to obtain permission to dispense over-the-counter medications to the camper if necessary.

No camper may carry, keep, or dispense for herself/himself or any other camper any prescription or over-the-counter medications. 

Non-compliance with this policy may result in dismissal from camp.

Specialty Camps

Health Form

Download the Health Form

  • All campers must have a completed Virginia School Entrance Health Form, or the equivalent form for their state of residence, on file prior to the start of camp. 
  • If you have previously submitted camper health forms to Summer at Maderia, no new health forms are needed UNLESS:
    • The actual physical examination was completed by your childs physician before 2017. Physical examinations completed in 2017, 2018, and 2019 are accepted for the Summer of 2019. 
    • Your camper is a rising 7th grader for the fall of 2019. All rising 7th graders must submit a new immunization record.
  • The camp health form includes three parts:

1. The Health Information Form, signed by the parent

2. An Immunization Record, signed by the doctor

3. A Physical Examination Record, signed by the doctor

  • For New Campers:
    • Immunization Records must be up-to-date and Physical Examination Records must have been completed after June 1, 2018.
  • For Returning Campers:
    • For campers entering 7th grade in Fall 2019, we require an updated Immunization Record.
    • Campers physical examinations on file must be dated 2017, 2018, or 2019. Examinations dated earlier will not carry over to 2019.  
    • If your childs health history has changed since you last submitted health forms to Summer at Madeira, please send an updated copy of his/her forms. 

Completed Health Forms must be submitted by June 1, 2019.

Health Forms that are not fully completed will not be accepted. Summer at Madeira reserves the right to withdraw registration for campers whose forms have not been received by June 1, 2019. 

Medication & Allergies

If your child has been prescribed medication he/she will need to bring onto the Madeira campus, you must:

1. Complete an Emergency Care Plan for all EpiPens

2. Complete an Asthma Action Plan for all Inhalers

3. Complete a Medication Consent Form for all other medications

All prescription medications must come to camp in their original pharmacy container, with the prescribing label attached. Please make sure your medication has not expired, as it will not be accepted.

The Madeira Health and Wellness Center is stocked with over-the-counter medications; therefore campers should NOT bring medications such as Acetaminophen (e.g. Tylenol), Ibuprofen (e.g. Advil), Diphenhydramine (e.g. Benadryl), Antibiotic Ointment (e.g. Neosporin), and TUMS if taken as needed to camp. The Health Center will contact the parents/guardian directly to obtain permission to dispense over-the-counter medications to the camper if necessary.

No camper may carry, keep, or dispense for herself/himself or any other camper any prescription or over-the-counter medications. 

Non-compliance with this policy may result in dismissal from camp.