Medical Release Form for Florida

Please print this form and complete it.  Attach a photocopy of both the front AND the back of your health insurance card.  If you have multiple family members attending, please complete one for EACH traveler, including a copy of the insurance card.  Please return to Mr. or Mrs. Kazin by WEDNESDAY, JANUARY 31ST.


In addition, all chaperones must complete a background check, including fingerprinting, before traveling.  Please contact Sheri Sochacki at for more information.  The background check takes time to process, so please begin this process as soon as possible.

Medical release and insurance form