Allergy & Diet Needs

Winter Weekend Allergy Information & Dietary Needs

Family Fest desires to meet the needs of everyone who comes to Winter Weekend. We understand that some people may have a special diet. We will do our best to meet your requirements with substitute/alternate food options. Please note that if a guest has a combination of these needs, or other dietary restrictions not listed, we may not be able to guarantee that we can accommodate your request.

Camper Allergy Medical Form

Please fill complete information on each individual person with an allergy or dietary need.

• Name*
  First Last
• Email
• Cell Phone
  In case we need to connect at Winter Weekend
• Date*
  MM slash DD slash YYYY
  Please fill in today's date.
• Is this Camper a child or an adult
  • Child
  • Adult
  • KC - Kid's Counselor
• Child Camper or KC Photo
  If this camper is a child or KC, it would be helpful for us to have a photo to attach to their allergy form. Please upload a photo here if you have one.
  Accepted file types: jpg, jpeg, png, gif.

• Allergies

• Allergy/Dietary
  Please choose the appropriate box.
  • Allergy
  • Dietary Needs
  • Medical
  • All of the above
• Camper Medical Condition
  Please describe this campers medical condition (i.e. Asthma, Allergy, etc.)
• Allergy Alert
  This camper has a DANGEROUS, life threatening allergyto the following foods:
• Specific Food Allergies
  This person has specific allergies to the following foods or ingredients:
• Possible Symptoms from this allergy
  • flushed face, hives, swelling or itchy lips, tongue, eyes
  • tightness in throat, mouth, chest
  • difficulty breathing or swallowing, wheezing, coughing, choking
  • vomiting, nausea, diarrhea, stomach pains
  • dizziness, unsteadiness, sudden fatigue, rapid heartbeat
  • loss of consciousness
• Other Possible Symptoms not listed above:
• Action - Emergency Plan
  • use Asthma Inhaler
  • use Epipen / Ana-kit immediately!
  • have someone call an ambulance and advise the dispatcher that a child is having an anaphylactic reaction.
  • if ambulance has not arrived in 10 to 15 minutes and breathing difficulties are present (eg. wheezing, coughing, throat clearing), give a second Epipen, if available.
  • even if symptoms subside entirely, this child must be taken to hospital immediately.
  • loss of consciousness
• Other Action Plans not listed above:
• Epipens / Ana-kit are kept
• Recommended substitute snacks
  Please list possible snacks that this camper can have.

• Diet

• Diet Situation
  Please tell us a little about your diet situation.
• Special Diet Needs
  Please check any special diet needs that apply to you.
  • non-celiac gluten free
  • egg free
  • dairy free
  • vegan
  • vegetarian
  • diabetic
• Please add any other special diet needs here.

Thank you! If there is more than one person in your family with allergy, medical or dietary needs, please fill out the form, submit it, and then return and fill out the form with the new information.

We strongly prefer to have this form ONE WEEK in advance so we can notify the camp. With certain dietary needs--including combinations of needs--you may be asked to provide your own food. Please know we will do everything in our power to provide alternatives to those who need it.

If you have other questions or needs, feel free to contact the Family Fest Ministries office directly at 952.881.0939.