Montecito Family Camp Health Form 

| Resume a previously saved form
Resume Later

In order to be able to resume this form later, please enter your email and choose a password.

Password must contain the following:
  • 12 Characters
  • 1 Uppercase letter
  • 1 Lowercase letter
  • 1 Number
  • 1 Special character
Montecito Sequoia Sunflake Logo
Your Reservation Details (NOTE: Please Fill Out One Form for Each Room or Cabin)









         To prepare for an enjoyable week together, our team needs to be aware of any health conditions which might influence your SAFETY in participation in activities. In addition to the information requested below, guests over age 65 who may need special attention and may be asked to provide additional information. Likewise, parents will be asked to give more detailed information to the Primary Program Coordinator for the younger children at camp. 


         Unfortunately, we are unable to provide one counselor for each child. If your child requires one-on-one supervision, a parent (or a hired babysitter) will need to stay with the child during activities until the child adjusts to the camp counselors caring for them. The parent also has the option to take their child with them and try again later for their child to join their children’s group. 


          If at any time within 5 days prior to your arrival any member of your family has exhibiting any COVID symptoms, or any other type of contagious illness, such as fever or chills, cough, shortness of breath, fatigue, etc., please call to discuss and/or to potentially reschedule your reservation. If any member of your family begins exhibiting symptoms of a contagious illness after your arrival, please inform the First Responder on site immediately for assessment/testing/treatment. Thank you for helping to keep all our campers as healthy and safe as possible during their vacation! 


          The camp has a First Responder on site for First Aid treatment. If medical advice is necessary, we may need to contact your family physician; Please have all of your doctors' names and phone numbers with you. Make sure you bring a copy of your Family's Health-Accident Insurance Card(s)/Information with you.  Thank you!  










Medical History








IMPORTANT:  For your well-being we need your family members' approximate age, medical conditions/restrictions, current medications, and any additional medical information that you feel is important to making your family's stay with us a healthy, happy  and safe one.  Please use Full names (first & last):
Family Member #1 (Primary Adult Guest for this room/cabin)




Family Member #2




Family Member #3




Family Member #4




Family Member #5




Family Member #6




Any Additional Family Member in the Same Room/Cabin




Additional Information

Electronic Signature