Youth Lock-In Nov. 23-24, 2018 PARENTAL PERMISSION FOR MEDICATION FORM
We are SO JAZZED that you will be joining us for the 2018 Lock-In! Remember, drop-off is at 7pm in Brown Hall and pick up is at 7am at Jennifer's house!

Cost is $20 per youth. 

Parent Permission to Give "Occasional" Over-the-Counter Medications if needed:

Over-the counter (OTC) medications are drugs that do not require a prescription and are purchased "over-the-counter." This form is required before over-the-counter medications can be administered during our "Youth Lock-In." Over-the-counter medications will be given according to the manufacturer's recommended dosage. Medications will only be administered by the Youth Director, Jennifer Murphy, or by an adult chaperone. You will be notified by text if your youth has been given any medication.

 

Listed below are examples of over-the-counter medications:

  • Antibiotic cream (ex: Neosporin)
  • Hydrocortisone cream (ex: Cortaid)
  • Benadryl Cream
  • Sunscreen
  • Ibuprofen (ex: Advil, Motrin)
  • Acetaminophen (ex: Tylenol)
  • Antacid (ex: Mylanta, Maalox, Tums, Pepto, Zantac)
  • Cold and Allergy Medications (ex: Sudafed, Claritin, Zyrtec, Benadryl)
  • Cough syrup or plain or medicated cough drops

 

 

Choose one:*