CAMP ROSENBAUM. Youth Citizenship Camp c/o Home Forward 135 SW Ash St Portland, OR JULY 22 JULY 27, Dear Resident,

Transcription

1 CAMP ROSENBAUM Youth Citizenship Camp c/o Home Forward 135 SW Ash St Portland, OR JULY 22 JULY 27, 2012 Dear Resident, Camp Rosenbaum invites you to send your child to our Youth Citizenship Camp July 22 through July 27, Housing Authorities throughout Oregon and SW Washington, along with the Oregon National Guard, the Portland Police Bureau, G.R.E.A.T. and Police Activities League (PAL) have partnered to create an annual summer camp for boys and girls ages 9 1/2 through 11, living in low income housing properties. There is no cost to attend Camp Rosenbaum. The camp is located at Camp Rilea on the Oregon coast near Warrenton, Oregon. Children who attend camp will be carefully supervised and receive a great deal of individual time and attention. Learning good citizenship is the camp objective. This is done by helping the children build a better self image through many activities: leather projects, arts and crafts, nature walks, trips to the beach, visiting the Seaside Aquarium and Astoria s Maritime Museum. We also have supervised sports, movies, fishing, swimming and a camp-out. NOTE: Children must be lice and nit-free to attend Camp. Each child will receive a pair of athletic shoes, as well as camp clothing such as sweatshirts & T-shirts. They also will bring home the items that they make in leather, arts and crafts and science. The children are served three nutritious meals a day and there are birthday celebrations for those children with birthdays during the week! The Camper Application and Ground Rules form must be mailed back to the address below no later than Monday, May 7, 2012 to be considered. You must submit a separate Application and Ground Rules form for each child, signed by the parent or legal guardian. You will be notified by June 22nd if your child is selected to attend camp. Bus transportation is provided. Children selected will be notified the week before camp where the pick-up location is and what time they need to be there. Children will be returned to the same location on July 27th between 2-3 PM. Only a limited number of children may attend camp and priority is given to children who have not attended before. Please mail the completed and signed Camp Application and Ground Rules form to: Camp Rosenbaum 2012 Home Forward Attn: Melissa Sonsalla 135 SW Ash Street Portland, OR No pre-camp physical will be needed but it is very important that you submit applications for only those children that are capable of participating in this very active camp schedule. The camp is not designed for children who are physically or mentally challenged. If you have any questions, need more applications or assistance in filling out your application, please call me, Melissa Sonsalla at or Leslie Crehan at Thank you! Sincerely, Melissa Sonsalla & Leslie Crehan, Camp Coordinators Camp Notification Letter

2 Office Use only: WVHA- HAP- SHA- VHA- WCHA- YCHA- NOHA- CCHA- LANE- CENTRAL 2012 Camp Rosenbaum Youth Citizenship Camp Application ONE CHILD PER FORM - PLEASE PRINT CLEARLY From which program does your household receive rental assistance? Please mark one: Section 8 Public Housing Other CHILD S NAME: Last First Middle Initial GENDER: Male BIRTHDATE: Month Day Year Age Race T-Shirt Size Youth PARENT(s)/ GUARDIAN NAME: Last First Middle Initial Adult Female Home Address: (include Apt. or Unit #) City: State: Zip Code: Home Phone: Work Phone: Cell Phone: Emergency Contact Name:(other than parent) Phone: Relationship: Health Insurance Company: Policy Number: Name of Child s Physician: Physician s Phone Number: Has your child attended CAMP ROSENBAUM before? Yes No Has your child attended ANY overnight camp before? Yes No Can your child swim? Yes No May photos be taken of your child to share with friends? Yes No May photos be taken of your child for fundraising/publicity purposes? Yes No Would you like your child to participate in a Mentor program after camp? Yes No Does your child have any special hobbies, talents or interests? If so, please list: Does your child belong to any clubs/organizations (example: Boys & Girls Club, Campfire, PAL, Boy Scouts?) If so, please list: Is it OK for your child to receive a free haircut at Camp Rosenbaum if he/she so desires? Yes No If Yes, with the following restrictions:

3 MEDICAL INFORMATION Please indicate any health concern that your child has by placing an X in ALL that apply Allergies (please use space below to list) Autism Bowel/Bladder Problems Bedwetting Diabetes Emotional/Behavioral or Learning Concerns Heart Problems Physical Injuries (recent) Seizure Disorder Skin Problems Sleep Walking Vision/Hearing Problems Chronic Illness Recent Surgical Procedure Please provide more specific information about identified health concerns including reasonable accommodations needed while at Camp Rosenbaum. YOUR CHILD MUST BE LICE AND NIT FREE TO ATTEND CAMP. When was your child treated for lice/nits? Date treated: MEDICATION Is your child currently taking any kind of medication? Yes No Will your child need medication while attending Camp Rosenbaum? Yes* No *If yes, fill out information below All medication must be sent to camp in its original prescription container with instructions for administering Name of Medication Time(s) To Be Given Example: AM/PM How Often Example: 2 times daily Purpose of Meds The Camp Rosenbaum medical staff maintains a small supply of common over-thecounter medications on site. These medications are administered, as needed, under the standing orders of the Rosenbaum consulting physician. Medications available for your child are: Non-aspirin pain relievers, antihistamines, cough drops and cough syrup, sunscreen, antibiotic cream/ointment, insect repellant, lotion/cream for chapped skin, cream for itching, gel/lotion for minor sunburns, anti-diarrheal tablets and meds for minor gastrointestinal complaints. The Health History form is checked for allergies before any medication is given.

4 PARENT OR GUARDIAN STATEMENT: I have read the Daily Activities description and understand the scope and potential demands of Camp Rosenbaum and, to the best of my knowledge, believe that my child is physically and mentally able to participate in Camp Rosenbaum s daily activities. My child is not suffering from, nor has been exposed to, any condition that might be harmful to other children or camp staff. I authorize the Camp Rosenbaum staff to administer the above-mentioned medication(s) while my child is at Camp Rosenbaum and I agree to send enough medication for my child for the entire week of camp. I release the Camp Rosenbaum Fund and all associated agencies, staff, and their representatives from any responsibility for accidents, injuries, or damages sustained by my child while participating in this program. I, the undersigned parent or legal guardian of the child listed on the reverse side of this application, give permission for the Camp Rosenbaum staff to authorize treatment and/or hospitalization that is necessary in case of medical emergency. I understand this consent is given in advance of any specific diagnosis or hospital care being required in order to provide authority for a licensed physician to render any and all diagnosis, treatment, or hospital care deemed advisable by the physician attending my child in case of medical emergency. All information given on this application is correct to the best of my knowledge. I completely understand all of the above. Signature of Parent or Legal Guardian: X Date signed: Camp Rosenbaum participates in the Summer Food Service Program. Meals will be provided to all children free of charge. The U.S. Department of Agriculture (USDA) and the State of Oregon prohibit discrimination in all USDA programs and activities on the basis of race, color, national origin, sex, religion, age, or disability. Send completed form NO LATER THAN MAY 7, 2012 TO: Camp Rosenbaum C/O Home Forward, Melissa Sonsalla 135 SW Ash Street Portland, OR (over)

5 CAMP ROSENBAUM YOUTH CITIZENSHIP CAMP GROUND RULES FOR GOOD CITIZENSHIP Camp Rosenbaum strives to be a healthy, caring environment for every child. In order to create the most successful and enjoyable time at camp we have put together a set of Ground Rules for Good Citizenship for all of us, both campers and staff to follow. To help accomplish this, we ask that parents and children review the list of ground rules outlined below. Parents and/or guardians, after you have read and explained these Ground Rules For Good Citizenship to your child, please sign this form and return it using the self addressed and stamped envelope provided with each application. If a camper chooses not to follow the ground rules, Camp Staff will discuss that choice with the camper. If the ground rules continue to not be followed Camp Rosenbaum reserves the right to dismiss the camper after discussing the situation with the camper s parent(s). As a Camp Rosenbaum Camper, I will: MY AGREEMENT 1. Use clean and positive language at all times. 2. Speak to and about other Campers and Camp Staff in the most supportive way possible. 3. Respect and leave alone the belongings of other Campers and of Camp Staff. 4. Always be respectful and truthful to Camp Staff. 5. Stay on Camp property at all times. 6. Bring all disagreements to Camp Staff to sort out and handle. 7. Leave all property better than how I find it. 8. Happily follow all the Camp rules at all times and participate in activities. I read and understand the rules listed above and agree to not break these rules. Camper Signature Date Parent/Guardian Signature Date What school does your child attend? SEE YOU AT CAMP ROSENBAUM!!!

6 The Campers Boys and girls ages 9-11 whose parents live in housing authority properties or who participate in the Section 8 rent assistance program may attend Camp Rosenbaum. No Cost to Families The camp is supported by its sponsors: the Oregon National Guard, housing authorities in Oregon and Southwest Washington, and public safety organizations, such as the Portland Police Bureau. In addition, Camp Rosenbaum receives generous donations from individuals and local organizations, including NIKE and Fred Meyer Camp Rosenbaum History Camp Rosenbaum was the vision of Fred Rosenbaum, ( ), who was Chair of the Housing Authority of Portland (now Home Forward) and an Oregon Air National Guard Assistant Adjutant General. After visiting Camp Rilea and realizing what an ideal camp setting it would be for children who lived in housing authority communities, he started the first camp in 1970 with a budget of $750 and a small but committed group of volunteers. In 1985 Governor Vic Atiyeh named the camp after this dedicated leader who worked so hard over the years to nurture a tradition that gives support, encouragement, and individual attention to young campers. Getting in Touch Parents receive a special phone number in their confirmation materials if they need to reach their child at camp. For more general information on Camp Rosenbaum, call or go the camp s website: Send your child to Summer Camp on the Beautiful Oregon Coast A fun, free week-long camp experience that reinforces Good Citizenship

7 Good Citizenship Encouraged Citizenship themes are promoted in fun ways at morning assemblies, and individual and team awards are given to campers whose behavior displays the values of working together, caring for others, fairness, and loyalty. Campers attend classes that are designed to help them resist gang activity and drug use. Experienced Staff Camp counselors and staff come from the sponsoring organizations and typically have many years of experience at Camp Rosenbaum. There are three camp counselors for each group of 10 children and a one-to-one staff to camper ratio. Special Gifts for Campers At the beginning of camp, each child receives a camp t-shirt, sweat shirt, and a pair of athletic shoes donated by NIKE. Campers choose books to read and take home at the end of the week. The Setting Campers travel by bus to beautiful Camp Rilea on the Oregon coast just south of Astoria. This location, which is home to Oregon s National Guard, is used as a summer camp by many community organizations, including the Boy Scouts. Fun Activities Camp Rosenbaum provides all of the traditional activities children love: art and science projects, leather crafts, horseback riding, story telling around the campfire, fishing, and swimming. There are daily skits, talent shows, physical fitness activities, and team sports. An overnight tent camping experience and field trips to the ocean and the Seaside Aquarium are always a special hit. The week ends with a rousing assembly and pinewood derby races. Health and Safety Meals are designed to be both delicious and nutritional. Special dietary needs can be accommodated. The medical staff at Camp Rosenbaum includes week-long coverage by nurses and medics, and a doctor for part of the week. Medics accompany the campers on field trips, and swimming is supervised by accredited lifeguards. Nurses dispense any medicine that children may bring with them.