The state of Connecticut requires that every camper have a health form on file at camp, including health history, immunizations, consent for treatment, emergency contact information and a record of physical examination completed by a physician within the past two years.

You may use the same form you submitted to your school, as long as the dates are current. The immunization record must include dates. No camper will be allowed to attend camp unless a current and complete health form is submitted.

Forms are due at least two weeks prior to the beginning of the session. Please click on the link below to download our medical form. Send completed forms to:

YWCA
Camp Aya-Po Office
135 Broad St.
Hartford, CT 06105

• Camp Aya-Po Medical Form (PDF / 119 KB)
• Authorization for Prescription and Non-Prescription Medications (PDF / 66 KB)