Civitan Acres 2019 Application

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Application Check List

OUR OFFICE MUST RECEIVE ALL OF THE FOLLOWING ITEMS BEFORE ANY GUEST CAN CHECK-IN FOR A VACATION STAY:

  • Civitan Acres Summer Vacation Application 2019 – This application can be completed online (below) or via downloadable PDF.
  • Medication Authorization Form(s) – Be sure to complete one of these forms per each medication sent, even over the counter meds.
  • Medical Form – must be less than one year old from date of camp session requested and completed by a physician
  • $125 Non-refundable deposit. Will be applied towards program fee. Payments may be made online here.
    Copy of Medical Insurance Card(s)

You may submit items 1 and 4 now, and turn in items 2, 3, and 5 prior to or at check-in.

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