Downtown Day Camp Vaccine Submission Form

Parent First Name: *

Parent Last Name: *

Parent Email: *

Parent Phone: *

*Please make sure you enter the same child first and last name that you entered on the Downtown Day Camp registration form.

Child First Name: *

Child Last Name: *

Child Date of Birth: * +

Child's School: *

Type of Vaccine Received: *

Date of First Vaccination Dose: * +

Date of Second Vaccination Dose (if already received): +

Please make sure your child's name and vaccination date/s are clearly visible before you upload your file: *