Registering Late? No problem, but please keep in mind the following late fees!

If we do not receive the registration and prescriptions at least 30 days prior to the start of session, you will be charged an additional $25.00 late fee. If we receive prescriptions less than 10 days before the start of the camp session, an additional $30.00 expedited shipping fee will be charged in addition to the late fee.

If your primary and/or secondary insurance has changed, please submit this form. If you have any questions, call us at 1 (951) 407-0707.

If you have a primary and secondary insurance, make sure to add both primary and secondary insurance information on the form, even if only one insurance has changed. This form will invalidate the previous insurance information you submitted.

Please be aware, in the case your new insurance denies the charges, we reserve the right to charge your credit card for the full cost of medication. All credit card charges from the Perris Hills Pharmacy will appear as a separate charge after your child returns from camp.

Download the PDF version of My Insurance Has Changed here.

MY CAMPER'S INFO
The information of the child going to camp
INSURANCE INFORMATION
Please leave fields blank that do not apply.
Primary Insurance
Secondary Insurance

A G R E E M E N T
By clicking "Submit" you agree to Perris Hills Pharmacy's, My Kids Camp Meds TERMS OF USE and PRIVACY POLICY AGREEMENT.