Post Office Box 7136
Myrtle Beach, SC 29572
(843) 449-0554
April 15, 2015
Hello All!
This letter is to inform you of SOS Health Care’s new summer camp format. This year, we will be splitting the camp into two sections; Camp at 21st Ave. N. and Career Camp. Career Camp will be geared towards transition aged campers as it will be focusing on instilling and strengthening life skills and career goals. The camp will be geared towards skills needed for independent living and exploring different working environments. Those enrolled in Career Camp will still be participating in weekly field trips with the other camp as well.
Throughout the summer we will be going on community outings, touring facilities for possible future employment, having special guest speakers, and providing a structured daily schedule for all the camp attendees. Camp counselors will be trained to assist campers with any needs and provide support throughout all of the activities.
Registration and Fees:
Camp slots will be available on a first come, first served basis, and there is a limited availability, so act quickly! Applications, registration fees, and first week’s tuition are due by April 22, 2015. Camp will run from June 8, 2015 – August 14, 2015. After-camp care will be available for an additional fee.
●Registration fee - $45.00 (non-refundable)
●Tuition for camp - $70.00 per week*
●Tuition for second child (sibling) - $50.00 per week*
●After-camp care (3:30-5:30pm) - $25.00*
*It is required to pay for all 10 weeks of camp regardless if the attendee is absent for any reason. Tuition may be paid on a weekly basis, but must be paid in full by August 7, 2015. ($700 for 1 child, $1200 for 2 children, $950 for 1 child with after-camp care, $1700 for 2 children with after-camp care).
Tuition includes field trips, outings, guest speakers, and bus transportation.
Schedule:
Camp will run from June 8, 2015 – August 14, 2015, Monday through Friday, 8:30 am to 3:30 pm. After camp care will be from 3:30 – 5:30 pm.We will be closedFriday July 3rd and Monday July 6th. You will be receiving a weekly schedule of our planned activities and outings. Career Camp will meet at our consignment store, “Making Change Consignment” (1106 N. Kings Highway in Myrtle Beach). Tentatively, we will be going on outings/field trips on Mondays, Wednesdays and Fridays. We will have guest speakers from the community coming to the store to speak with us on Tuesdays and Thursdays.
Lunch and Snacks:
Please provide a labeled lunch, beverages, and snack (if desired) for your child. Please provide information on any diet restrictions and allergies.
Attire: Please make sure your child has closed-toed shoes either packed or worn. Please pack a bathing suit and towel daily as the kids will be attending field trips to the pool. Feel free to provide a change of clothing if you feel necessary. Please label clothing so it does not get misplaced.
Medications:
Please label any medications your child might need throughout the day with dosage instructions. Please provide, as needed, medications such as inhalers, Epi-pens, etc. We must have a copy of your child’s dosages and times as well as a permission form for us to administer these medications with your signature for our records.
Please “like” us on SOS Health Care’s Facebook page and make us one of your favorites in order to receive the most up-to-date information on camp.
In the event of an emergency, or any questions or concerns, please don’t hesitate to contact me, Sarah Pope, Executive Director, SOS Health Care at 843-449-0554.
Parent Signature: ______Date: ______
Print Name: ______
Please mail this completed application, registration fee, and first week’s tuition (including After Camp) to:
SOS Health Care
PO Box 7136
Myrtle Beach, SC 29572
Post Office Box 7136
Myrtle Beach, SC 29572
(843) 449-0554
CAREER CAMP REGISTRATION
Child’s Name: Birth Date: Age:
Address:
Parent/Guardian:
Home Phone: Cell Phone:
E-Mail Address:
Emergency Contact Person:
Relationship to Child: Home Phone:
Cell Phone:
Medical Information:
Medical Diagnosis:
Is there a current condition of medical history of:
A)Seizures
B)Visual/Hearing Impairment
C)Allergies
D)Infections
E)Other
Medications:
Will your child/children need medications while attending program?
YES NO
If you checked YES please complete the following section.
Name of Medication 1: Purpose:
Dosage and time given: How given:
Side effects:
Prescribed by Dr. :Phone:
Name of Medication 2: Purpose:
Dosage and time given: How given:
Side effects:
Prescribed by Dr. :Phone:
Please attach additional pages if necessary.
I authorize administering the described prescription medications:
Parent/Caregiver SignatureDate
Print Name ______
Diet:
Food allergies:
Specific diet:
Choking/swallowing risks:
Supervision: please place an ‘X’ by the level of supervision your child requires.
Level 1 (Will stay with group with minimal supervision)
Level 2 (Will stay with group with supervision in close proximity)
Level 3 (Will wander from group, must have one-to-one supervision)
Assistance: please place an ‘X’ on the line if your child requires assistance with the following
Toileting Eating Communication
Behavior: Please describe any behavior problems such as hitting, screaming, refusing to follow directions, self-abuse, etc. and how you would like the Program Staff to respond to such behaviors:
Post Office Box 7136
Myrtle Beach, SC 29572
(843) 449-0554
SUMMER AFTER CAMP PROGRAM
Overview: The after camp program will have the same curriculum and agenda as the after-school program. There will be planned activities such as wellness/fitness groups, social group games and activities, gardening, crafts, snacks, etc.
Program Hours: The after camp program will run as a continuation from camp, from 3:30-5:30. As far as closure days, please see the camp welcome letter.
Registration and fees: The cost of the after camp program will be $25 per week and will be collected according to the same tuition policy as camp.
Late Fees: If you are unable to get here by 5:30PM to pick up your child, there will be a late fee charge of $5 for every 10 minutes you are late.
Please sign that you have read and understand the Summer After Camp/Late Fee Policy:
Parent/Caregiver Signature:Date:
Print Name ______
Post Office Box 7136
Myrtle Beach, SC 29572
(843) 449-0554
TUITION POLICY
Tuition for Career Camp will be collected on the Friday before each week in the amount of $70.00 per week. Example: Payment on June 12 is for camp tuition for the following week (June 13-17). Failure to make a payment by this day means your child will not be allowed to attend the following week. The same policy applies for After Camp program tuition.
Please make checks payable to SOS Health Care. We will also be accepting all major credit/debit cards via the Square app, as well as cash.
Your first week’s payment ($70.00) and a non-refundable registration fee of $45.00 is due by April 22, 2015 along with your registration form and all other documents to reserve your child’s slot.
You are required to pay for all 10 weeks of camp regardless if your child is absent for any reason. Tuition may be paid for on a weekly basis or in full at any time. The final payment must be paid by August 7, 2015.
Please sign and date below that you acknowledge and accept our payment policy.
Signature______Date______
Printname ______
Post Office Box 7136
Myrtle Beach, SC 29572
(843) 449-0554
PERMISSION TO ADMINISTER MEDICATION
Child’s Name: ______
Medication:______
Time of distribution: ______
Parent/Guardian’s Name (print):______
By signing below I authorize for the camp coordinators, (Eileen Law, Jessica Paternoster and Ashley Brigham), or the Executive Director of SOS, Sarah Pope, to administer my child their medication. No other person will have access to your child’s medication.
Parent/Guardian signature: ______Date:______
Post Office Box 7136
Myrtle Beach, SC 29572
(843) 449-0554
MODEL RELEASE
I hereby give permission to SOS Health Care, Inc. to use my name and photographic likeness in all forms of media for advertising, trade and any other lawful purposes. I am doing so without compensation of any sort.
Camper’s Name:
Signature: Date:
If model is under 18; I, , am the parent/legal guardian of the individual named above. I have read this release and agree to its terms.
Parent Signature: Date:
Post Office Box 7136
Myrtle Beach, SC 29572
(843) 449-0554
WAIVEROFLIABILITY/HOLDHARMLESSAGREEMENTFOR TRANSPORTATION BY ASOS HEALTH CARESTAFFMEMBER
TransportingstudenttoandfromSOS HEALTH CARErelatedactivitiesbyautomobilebyaSOS HEALTH CARE Staffmember.
Pleasereadthisformcarefullyandbeawareinsigningthiswaiverforyou or yourminorchild/wardtobetransportedbyautomobilebyaSOS Healthcare staffmemberandanyactivitiesassociatedtherewithyouwillbewaivingyourrightstoallclaimsforinjuriesyouand/oryourminorchild/wardmightsustainarisingoutofbeingtransportedbyautomobilebyaSOS HEALTH CAREstaffmember.
Inconsiderationofme or myminorchild/wardbeingallowedtobetransportedbyautomobilebyaSOS HEALTH CARE staffmember,IrecognizeandacknowledgethattherearecertainrisksofphysicalinjuryassociatedwithbeingtransportedbyautomobilebyaSOS HEALTH CAREstaffmember.Iagreetoassumethefullriskofinjuriesthatmaybesustainedby me or anyminorchild/wardofmine,asaresultofbeingtransportedbyautomobilebyaSOS HEALTH CAREstaffmemberandallactivitiesconnectedorassociatedtherewith.Iagreetowaiveandrelinquishallclaimsonbehalfof me or myminorchild/wardthattheminorchild/wardmayhaveagainstSOS HEALTH CAREasaresultoftheminorchild/ward’sbeingtransportedbyautomobilebyaSOS HEALTH CAREstaffmember.
IdoherebyfullyreleaseanddischargeSOS HEALTH CAREanditsofficers,agentsandemployeesfromanyandallclaimsfrominjuries,damageorlosswhichI,oranyminorchild/wardmayhaveorwhichmayoccurtomyminorchild/wardonaccountofhis/herbeingtransportedbyautomobilebyaSOS HEALTH CAREstaffmember.IfurtheragreetoindemnifyandholdharmlessanddefendSOS HEALTH CARE,itsofficers,agentsandemployeesfromanyandallclaimssustainedbymeormyminorchild/ward,andarisingoutof,connectedwith,orinanywayassociatedwithbeingtransportedbyautomobilebyaSOS HEALTH CAREstaffmember.
TheinvalidityorunenforceabilityofanyoftheprovisionshereofshallnotaffectthevalidityorenforceabilityoftheremainderofthisAgreement.
IhavereadandfullyunderstandtheaboveWaiverandReleaseofallclaims.
Name(s)ofMinor, if applicable
PrintedNameof Student or Parent/LegalGuardian
Signatureof Student Parent/LegalGuardianDate
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