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4 Page 4 WE ARE ACA ACCREDITED! (AND PROUD!)

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24 KEEP UP WITH CAMP ALL SUMMER LONG! Stay in touch with your camper at Camp Wasiu II with Bunk Notes. Your message will be delivered to the camp within 24 hours. No need to wait for snail mail Bunk1 makes it easy to communicate with your child. Follow Bunk1 on Facebook and Twitter for the latest updates and deals! GET STARTED TODAY! Go to RETURNING PARENTS will login using their address and password. NEW PARENTS will click Need an account or have an invitation code? and complete the basic form. The Invitation Code for Camp Wasiu II is: WASIUB1 You will be prompted to select a bundle for access to your Parent Portal. Bundles include credits for you to send Bunk Notes and enhance your notes with borders, photos, sports scores, and puzzles. SENDING BUNK NOTES Send Bunk Notes day or night! Your camp receives a pdf at 7am PST each day containing all Bunk Notes received in the last 24 hours. Camp prints each Bunk Note and delivers them to your camper with the regular mail. You can purchase more credits anytime in the Bunk Notes menu. On the go? Purchase Bunk Notes Express and receive a unique address to send your Bunk Note directly from an account. Your message is still delivered as a Bunk Note. Each time you send a message, 1 credit is deducted from your account. Your Bunk Note will not be sent via Bunk Notes Express unless you have credits in your account. FREQUENTLY ASKED QUESTIONS: Can other relatives use these services? Absolutely! In your Quick Links you ll select Invite Family Members, enter their details and they will be sent an . PLEASE NOTE this will prompt them to set up their own account. It does not provide them access to your account OR your Bunk Note Credits. Questions or Problems? The Bunk1 team is available to support you 7 days a week during peak season. They guarantee a response within 24 hours and it's usually much quicker than that. Please call Bunk1 at or support@bunk1.com.

25 Page 1 of 4 Camp Transportation Release Form This form must be completed for ALL campers under age 18, even if a parent/guardian is providing all transportation. Please print this form singlesided (not doublesided) and fill out all sections (including name, address, and parent/guardian info.), as this document will be separated from the rest of the packet. This form is to be filled out each summer for each camp program/event. Present this form at checkin. Participant Information Name Program name Street address City State Zip Parent/Guardian Emergency Contact Information First Custodial Parent/Guardian Telephone: Day Evening Cell Does this person have permission to pick up the camper? Yes No Second Custodial Parent/Guardian Telephone: Day Evening Cell Does this person have permission to pick up the camper? Yes No Please circle one response for each of the following statements. This MUST match your online registration. My camp is arriving at camp by: Car Bus from Reno Bus from Truckee My camper is leaving camp by: Car Bus to Reno Bus to Truckee Are there any custody situations of which we need to be aware? Yes No If yes, please explain. Please identify any additional persons who MAY pick up your camper. We cannot release campers to any individuals not noted on this form. This box must be completed for attendance. Name Relationship to camper Phone 1 Phone 2 Name Relationship to camper Phone 1 Phone 2 Name Relationship to camper Phone 1 Phone 2 I confirm that the individuals listed above have my permission to pick up my camper. I also understand that the adult picking up my camper will be required to show photo ID. Printed Name Date Signature This section is to be completed at pickup: I am an approved adult listed on this form. I am confirming that I am picking up the youth camper named on this form. Printed Name Date Signature

26 Page 2 of 4 Camp Health History Form for Children & Adults This form must be completed for ALL camp participants (youth AND adults). Please fill out the name and address section, as this document will be separated from the rest of the packet. The information on this form is gathered to provide camp health care personnel the background necessary to provide appropriate care. Please provide complete and correct information. Keep a copy of the completed form for your records. This form is to be filled out each summer for each camp program/event by parents/guardians of minors or by adults themselves. Please staple pages 2 4 together and present at checkin. Participant Information Name Birth date Age at camp Home address Street address City State Zip Parent/Guardian Emergency Contact Information First Custodial Parent/Guardian Telephone: Day Evening Cell Second Custodial Parent/Guardian Telephone: Day Evening Cell If not available, in an emergency, notify: Relationship to participant Telephone: Day Evening Cell Insurance Information Is the participant covered by insurance? Yes No If yes, copy of insurance card must be attached. If so, indicate carrier or plan name Group Insurance ID # Name of insured Relationship to participant Medical Providers Name of family physician Telephone Address Name of family dentist/orthodontist Telephone Address Is there anything we should know about the camper? Please describe any physical, mental, or psychological conditions requiring medication, treatment, or special restrictions or considerations while at camp. Dietary Restrictions Allergy Information Allergic to: Describe reaction and management of the reaction:

27 Page 3 of 4 Prescriptions and/or Daily Medications Medication Name: SUN MON TU WED TH FRI SAT Dose Time(s) to give Medication Name: SUN MON TU WED TH FRI SAT Dose Time(s) to give Medication Name: SUN MON TU WED TH FRI SAT Dose Time(s) to give My camper uses an EpiPen. Yes No If yes, should the EpiPen be kept on the camper, her counselor, or at the Health Hut? My camper uses an inhaler. Yes No If yes, should the inhaler be kept on the camper, her counselor, or at the Health Hut? Common overthecounter medications are stocked in the Health Hut and will be administered at the discretion of the camp health staff to your camper if permission is given below. Medication will be administered based printed label s symptoms and suggested dosage. Circle all that apply. Tylenol (Children s) Calamine and/or Caladryl Lotion Sudafed Tums Tylenol (Adult) Benadryl (Children s) Robitussin DM Neosporin Ibuprofen (Advil and/or Motrin) Benadryl (Adult) PeptoBismol Sun Screen Bug Spray/Insect Repellant Hydrocortisone Cream Overthecounter medication notes: This box must be completed for attendance. Parent/Guardian or Adult Authorization: This health history is correct and complete to the best of my knowledge. The person herein described has permission to engage in all camp activities except as noted. I understand and agree to abide by any restrictions placed on my participant in camp activities. I attest that all immunizations required for school are up to date and agree that the date of the last tetanus shot is provided. I hereby give permission to the camp to provide routine health care, administer prescribed medications, and seek emergency medical treatment including xrays or routine tests. I agree to the release of any records necessary for insurance purposes. I give permission to the camp to arrange necessary transportation for me/my child. I have listed the medication dosage and administration instructions (if applicable). I authorize camp health staff to administer the above listed medications to my camper during her participation. I understand that GSSN is not liable for lost or damaged medical equipment. If I cannot be reached in an emergency, I hereby give permission to the physician selected by the camp to secure and administer treatment, including hospitalization, for the person named above. I understand every effort will be made to contact me or the emergency contact noted above before taking this action. This form may be photocopied for trips out of camp. Printed Name Date Signature

28 Page 4 of 4 THIS ENTIRE SECTION MUST BE COMPLETED BY LICENSED MEDICAL PERSONNEL FOR ALL CAMPERS (YOUTH AND ADULT) ATTENDING A CAMP WASIU II SESSION THAT IS FOUR (4) NIGHTS OR LONGER. A physical is required for ALL campers that are attending a Camp Wasiu II session that is four (4) nights or longer. The physical exam must be current within 12 months of the camper s first day at camp. Date of Examination Height Weight BP Please circle the appropriate number for each system examined during the physical. 1 = Within normal 2 = Abnormal finding 3 = Referred for evaluation or treatment HEENT Neurological Skin Lungs Abdomen Heart Extremities Urinary Vision Date of Last Tetanus Shot (Required for participation in camp) Record of Past Medical Treatment (including treatment of any chronic/recurring illnesses, surgeries, etc.) Activity Exemptions The camp day includes high activity levels at elevations above 6000 feet. Are there any camp activities from which the camper should be exempted for health reasons? Yes No If yes, please describe: This box must be completed for attendance IF the camper will attend a Camp Wasiu II session lasting 4 nights or longer. Printed name & title of licensed medical personnel Practice / Clinic Name Phone Address Signature Date

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