This document is provided by Fort Caswell in the event a participant requires medical attention while on Fort Caswell's property. This form authorizes the claimant to this paid medical benefit assuming the forms are completed, signed and returned with any appropriate bills or EOBs as requested from the insurance provider.

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For the most efficient processing of relevant medical claims, Fort Caswell representatives recommend that each group leader have parents complete and sign the "Claimant Certification" portion of the form before camp to be kept on file with the group leader at camp. In the event of an accident or emergency, the injury information will need to be added and the form will be ready to submit for a claim.