Guidelines for completing expedition forms:
Application Materials for Parent/Guardian to complete:
- Student Application, Medical History and Tuition Agreement
- Consent and Waiver form (for Non-DCF Youth) or
- DCF Consent and Waiver form (for DCF Committed youth)
- Authorization for Disclosure of Information
Medical Forms needed:
- Copy of a recent school physical (not more than 2 calendar years old. Please submit prior to course start date. This form is also known as the State of CT-Department of Education, Health Assessment Record)
- Physician’s Authorization Form
- Non-Prescription Medication Authorization (OTC) – to be completed by Pediatrician for any non-prescription medication (ibuprofen, Tylenol, vitamins, other) that the applicant may need during the expedition.
- Prescription Medication Authorization (PEDIATRIC) – to be completed by Pediatrician for any prescribed medication that the youth will need.
- Prescription Medication Authorization (PSYCHIATRIC) – to be completed by Psychiatrist/prescriber for any Psychotropic medication that the youth will need.
Application Materials for Referring Agent to complete:
- Referring Agency Pre-Enrollment Interview Form
- Student Contract – to be completed by Referring Agent, youth and parent.
Short Course Forms:
- 1-Day Application and Medical History Consent and Waiver
- 2-Day (Overnight) Application and Medical History Consent and Waiver