POST / AGENCY ONLINE REGISTRATION

MUST BE COMPLETED BY THE POST/AGENCY’S LEAD ADVISOR.

THE DEADLINE IS 6/23/2024.

PAYMENT FORM OF A CHECK OR PURCHASE ORDER IS DUE BY 7/5/2024

MAKE CHECKS PAYABLE TO:

NERLEEA

MAIL CHECKS OR PURCHASE ORDERS TO:

NERLEEA PO BOX 253 BETHLEHEM, CT 06751

There is a different deadline for this form and payment because some agencies have to wait until after the start of the fiscal year to submit payment.

NOTE: NO PAPERWORK SHOULD BE MAILED IN. ONLY MAIL IN YOUR PAYMENT

CADET REGISTRATION/MEDICAL PACKET

THE PACKET MUST BE DELIVERED TO THE ACADEMY AND HANDED TO THE REGISTRATION STAFF ON THE MORNING OF REGISTRATION.

(THE PACKET IS NOT TO BE MAILED IN)

THE PACKET INCLUDES THE FOLLOWING:

• EMERGENCY CONTACT
• PERMISSION TO TREAT/TRANSPORT TO A MEDICAL FACILITY
• PHOTO VIDEO RELEASE
• SUNSCREEN ADVISORY
• EMERGENCY CONTACT LIST
• OVER-THE-COUNTER MEDICATION APPROVAL
• IMMUNIZATIONS RECORDS (Please provide a copy of the current up-to-date immunization record. School records are accepted)
• MEDICATIONS
• YOUTH CAMP HEALTH EXAM/RECORD (BASIC MEDICAL FORM) MUST BE COMPLETED BY DOCTOR

CADETS WITH MEDICATION, FOOD/DRUG ALLERGIES, OR SPECIAL DIETARY NEEDS

Parents of cadets who require prescription medication, have food/drug allergies, or have special dietary needs must also complete the HIPAA-protected online form in addition to providing hard copy forms.

Please contact our medical director, SERGEANT TIMOTHY FEDOR, with any questions or concerns regarding immunization records at TFEDOR@TRUMBULL-CT.GOV