His Path Developmental Day Program

Field trips may include swimming and participants will be required to take a swimming test to determine their swimming abilities.

Special note: If any medication is to be given while the participant is at His Path, be sure that it is sent in the original prescription containers, with the participant’s name and instructions on the bottle. Be sure that the dosage on this application and on the bottles are the same. Parental permission for medicine distribution is required.
***A copy of current (within one year) physical will be required to be submitted with registration.

I give my permission for any medical treatment necessary for the participant’s health and well‐being.

NOTE: Please provide copy of all insurance/Medicaid/Medicare ID card(s)

All participants are required to have permissions signed by a parent or guardian.