enrollment forms

Camper’s Full Name: _______________________________
ENROLLMENT FORMS
Welcome! We're happy you chose SuperCamp as part of your 2013 summer experience!
We encourage you to make us a full partner in achieving your child’s successful SuperCamp experience by
providing all relevant information. SuperCamp is an academic and life skills program and includes candid
discussions about students’ personal experiences. SuperCamp does not provide therapy and is not
appropriate for students needing support for emotional or behavioral issues. Please note that applications for
enrollment can be declined and/or students dismissed from SuperCamp based on our responsibility to
maintain a positive camp environment for all participants.
We are excited about getting to know your child and participating in his/her growth and learning. Thank you
for your thoughtful contribution to this end.
Following is a list of all the enrollment forms. Please return all forms fully completed to our Oceanside office by
the date specified in the cover letter.
Please be sure to read the above section before completing the following required forms.
You may keep this sheet for your records.
REQUIRED FORMS:
them off below.
 1. Confidential Student Profile (three pages)

2. Agreements
 Parent signature
 Student signature

3. Physicians Health Report (completed by family physician)

4. Travel Itinerary
 Copy of Airline itinerary
5. Medical Release
 Release Signature


 Arrival Info
 Departure info
 Medical Insurance
 Student Photo
6. Key/Damage Deposit (signature and deposit)
ADDITIONAL FORMS (optional):

7. SuperCamp Product Order Form

8. Learning Forum SuperCamp Scholarship Donation Form
Also find an enclosed General Information, Suggested Packing List, Dormitory Information and details related
to Communication during camp. These pages are for your information do not need to be returned.
QLN/SuperCamp
1938 Avenida del Oro, Oceanside, CA 92056
Phone: 800-285-3276  760-722-0072  Fax: 760-305-7770
E-mail: [email protected]  www.QLN.com
Confidential Student Profile
HOUSEHOLD INFORMATION
HEALTH HISTORY
Student’s legal name: _____________________________________
Describe your child’s past and current health: _________________
Student’s email address: __________________________________
_______________________________________________________
Student cell phone: (
_______________________________________________________
) ________________________________
Student date of birth: _____________________________________
Mom’s cell phone: (
) __________________________________
Mom’s employer: ________________________________________
Mom’s position: _________________________________________
Dad’s cell phone: (
)___________________________________
Please check all of the following that apply to your child:
Allergies:
 Asthma
 General
 Food
 Bee Stings
 Other*
 Diabetes  Epilepsy  Other chronic illness
* Record medication allergies under “Medication Information”
on next page.
Dad’s employer: _________________________________________
Please explain any selected above: __________________________
Dad’s position: __________________________________________
_______________________________________________________
Primary family email address: ______________________________
_______________________________________________________
Will you be traveling while your child is at camp?
 Yes
 No
If yes, please provide the following info:
Has your child seen a counselor, psychotherapist or psychiatrist in the last
five years?
 Yes
 No
Travel dates: ___________________________________________
If yes, please state the reason for counseling as well as when and how long
your child took part in counseling.
Destination: ____________________________________________
__________________________________________________
Telephone: (
__________________________________________________
) _______________________________________
EMERGENCY CONTACTS (other than yourself)
Name: _________________________________________________
__________________________________________________
Relationship: ___________________________________________
What essential and pertinent health information should the SuperCamp
Wellness Person know about your child?
Day telephone: (
__________________________________________________
) ___________________________________
Evening telephone: (
)________________________________
Name: _________________________________________________
__________________________________________________
__________________________________________________
Relationship: ___________________________________________
Day telephone: (
) ___________________________________
Evening telephone: (
) ________________________________
 Married
 Divorced
 Single
 Separated
 Other
If divorced/separated, who has custody of child?
 Mother
 Father
 Joint
If joint, do both parents agree to child attending SuperCamp?
 Yes
 No
If no, does enrolling parent have the right, without the consent of the
other parent, to send the child to SuperCamp?
 Yes
 No
Recent death, divorce, or other stressful situation in the family?
 Yes
 No
If yes, please explain: _________________________________________
___________________________________________________________
Does your child know that he/she is going to SuperCamp?
 Yes
Do you have a primary physician?  Yes
 No
If yes, please provide the following:
BACKGROUND INFORMATION
Parents are:
PHYSICIAN INFORMATION
 No
If no, please explain why and indicate when child will be informed.
__________________________________________________
Physician/Practice name: __________________________________
Physician telephone: (
) _________________________
PHYSICAL EXAMINATION
SuperCamp requires a physical examination within the 12 months prior to
the start of camp. All immunizations must be up to date. (Please see
Physician’s Health Report form.)
Date of last physical exam: ______________________________________
Date of scheduled appointment: _________________________________
Full participation in camp activities?  Yes
 No
If no, please explain: ___________________________________________
____________________________________________________________
____________________________________________________________
Confidential Student Profile (page 2)
MEDICATION INFORMATION
Is your child allergic to any medication?
BEHAVIOR
 Yes
 No
Please specify:_______________________________________
Medication needed while at camp?
 Yes
 No
To give your child the best opportunity to succeed, all medications
currently used during the school year for attention and/or hyperactivity
should also be used at SuperCamp. All medication must be checked in at
registration (with the exception of inhalers, EpiPens, and birth control
pills) and must be in original prescription containers that include
patient name and dosage information.
Medication: ______________________________________________
Purpose: _________________________________________________
Dosage: __________________________________________________
Because SuperCamp does not provide therapy and is not
appropriate for students needing support for emotional or
behavioral issues, we would like you to answer the following
questions.
If you answer yes to any of the following questions, please explain
fully.
Has your child an expressed interest in leadership programs?
 No
 Yes
Explain: _________________________________________________
________________________________________________________
________________________________________________________
Is your child involved with any extra-curricular activities at school or
in your community?
 No
 Yes
Medication: ______________________________________________
Explain: __________________________________________________
Purpose: _________________________________________________
________________________________________________________
Dosage: __________________________________________________
________________________________________________________
Medication: ______________________________________________
Purpose: _________________________________________________
Dosage: _______________________________________________
Has your child been involved with administration services for
disciplinary actions in the last 12 months?
 No
 Yes
Explain: __________________________________________________
________________________________________________________
SOCIAL SKILLS
Does your child work well in a cooperative group setting?
 Yes
 No
 Don’t Know
Does your child socialize with a group of friends?
 Yes
 No
 Don’t Know
Does your child avoid inappropriate risky behaviors?
 Yes
 No
 Don’t Know
________________________________________________________
Has your child been expelled or suspended for any reason in the past
12 months?
 No
 Yes–Suspended
 Yes–Expelled
Explain: __________________________________________________
________________________________________________________
________________________________________________________
Additional Comments: ______________________________________
________________________________________________________
________________________________________________________
________________________________________________________
REASONS FOR SUPERCAMP
What are your top three reasons for sending your child to SuperCamp?
 Study skills/Improved grades
 Organization
 Self-esteem/Confidence
 Social/Communication
 Future academic preparedness
 Fun
 Motivation
 Goal-setting
 Other _______________________________________________
_______________________________________________________
Has your child ever exhibited any violent behavior towards others?
 No
 Yes
Explain:_________________________________________________
________________________________________________________
Has your child exhibited any self-harm behaviors in the last 12
months? (i.e. cutting, eating disorder, suicide attempt)
 No
 Yes
Explain: __________________________________________________
________________________________________________________
Confidential Student Profile (Page 3)
LEARNING CAPABILITIES
Current GPA: _________________________________________________
In which of these areas does your child show interest and/or aptitude?
 Art / Graphic Design
 Organization skills
 Writing / Reading
 Dance / Athletics
 Leadership
 Mathematics
____________________________________________________________
 Music
 Other: _________________
_______________________________________________________
 Community Service
Does your child have an educational consultant or academic advisor?
 Yes
 No
If yes, please explain: __________________________________________
Has your child participated in any of the following:
 Advanced Placement
 Honors
 International Baccalaureate
 ROTC / ROP
 GATE
 AVID
What additional information can you provide about your child’s
academics?
_____________________________________________________
_____________________________________________________
_____________________________________________________
Has your child been diagnosed with any of the following?
 Attention Deficit Disorder
 Hyperactivity
_____________________________________________________
 Dyslexia
 Dysgraphia
_____________________________________________________
 Other (please be specific):
SIGNATURE
Does your child have trouble following directions and focusing attention?
 Yes
 No
If yes, please explain: __________________________________________
____________________________________________________________
____________________________________________________________
REPORT CARD
Please attach a copy of your child’s most recent report card. Knowledge of
your child’s strengths and weaknesses in a learning environment will
provide invaluable information for us. (Please attach report card copy in
space provided below.)
All information provided in this Confidential Student Profile (pages 1 to
3) is complete and true to the best of my knowledge.
Sign and Date:_____________________________________________
Agreements
TRANSFER POLICY
CAMP DISMISSAL
Once enrolled in a camp session, transfer to a different campus
(depending on availability) is possible if requested at least two weeks (14
days) prior to the old and new camp start dates. Additional expense will
not be incurred unless the new program fee is higher.
In order to maintain the positive environment of the camp and protect all
participants, SuperCamp reserves the right to dismiss any student who
breaks any of the following agreements. If a student is dismissed, parents
will be contacted to make immediate travel arrangements, and no refund
will be considered.
Being on Location: Students agree to stay on site in the areas designated by
the staff for the duration of the camp.
Respect for Other People: Students agree to respect the rights and safety of
others and not exhibit inappropriate physical and/or verbal behavior.
Respect for Possessions of Others: Students agree to respect the privacy
and possessions of others.
Respect for Campus Property: Camps are held on private property and
students agree not to damage, alter, or remove anything from the campus.
Parents are liable for damage caused by their child.
Forbidden Items: Cigarettes, chewing tobacco, alcohol, marijuana, weapons,
chemicals, animals, over-the-counter medications, prescription drugs not
prescribed in the student’s name, or abuse of drugs prescribed to the
student, are forbidden at SuperCamp. If a student is found in possession of
or using any of these items he/she will be dismissed from camp. In cases of
illegal substances or weapons, the local authorities will be contacted. If a
student presently smokes, we suggest quitting at least two weeks prior to
camp. Nicotine patches and/or Nicorette gum may be used at camp if
coordinated through the Wellness Person with parental permission noted in
the Health History section of the Confidential Student Profile form
CANCELLATION POLICY
Notification of withdrawal from SuperCamp must be made in writing. The
following cancellation fees apply based on the date your written notice of
cancellation is received in the SuperCamp Oceanside office:
Cancellation Notice Received
Cancellation Fee
September 1 – December 31
January 1 – February 28
March 1 – March 31
April 1 – April 30
May 1 – May 31
Beginning June 1
$ 500
$ 750
$ 1,000
$ 1,250
$ 1,500
Full tuition
The following additional policies apply:

In the event of a physical illness or injury to the student necessitating
st
cancellation on or after June 1 , 50% of the cancellation fee may be
applied to a U.S. SuperCamp session the following year. In order to
qualify for this "rollover" we require written certification by the
attending physician at the time of cancellation that the nature of the
illness or injury prevents the camper from safely participating in any
camp session during the current year.

If a child is a "no show," no refund is possible as expenses have
already been incurred. If a child has not arrived at SuperCamp by
midnight on day one, he/she will be considered a "no show."
EARLY DEPARTURE INSURANCE
There are no refunds offered once a student arrives at camp unless you
purchase the Early Departure Insurance (EDI), which protects your
investment in camp tuition if your child leaves early. To qualify for EDI,
you must purchase the plan at least 24 hours prior to the start of camp.
You will receive 75% of the prorated tuition if your child leaves early due
to illness that develops any time after arrival at camp, or for reasons of
voluntary withdrawal after the first two days of camp. No refund is
possible for voluntary withdrawal before day three of camp. The Early
Departure Insurance premium is $95 and is not refundable. To purchase
Early Departure Insurance, please call our Customer Service Department
at 800-285-3276.
Exclusions: No refund will be given for the following:
1.
2.
3.
4.
5.
6.
7.
8.
Failure to attend camp for any reason (see "Cancellation Policy")
Temporary absences
Any withdrawal prior to or within the first two consecutive calendar
days of the camp session (except for illness or injury)
Dismissal from camp (see "Camp Dismissal")
Boycotting of camp by the camper
Rebellion, riot or civil commotion
Destruction of any camp facility due to any cause
Closures due to national or natural disasters beyond our control
including widespread illness on campus
DRESS CODE
Students are expected to observe a mode of dress and personal grooming
and hygiene that are supportive of a positive learning environment
promoting self-respect. We do not allow attire that displays inappropriate
slogans and images or clothing that is sexually suggestive. Any student
wearing inappropriate attire will be required to change his/her clothes.
LIABILITY
I understand that SuperCamp will take every possible precaution to ensure
the health and safety of all students. I give consent to SuperCamp staff to
inspect my child’s room and/or property. I agree to indemnify and hold
SuperCamp and its agents, including On The Edge Productions, harmless for
any and all liability incurred as a result of my child’s participation. As
consideration for my child’s participation, I agree to assume full
responsibility for any personal loss, injury, illness, medical supplies, or
medication. I also assume full responsibility and consideration if my child is
dismissed from SuperCamp, and agree to make immediate travel
arrangements, at my own expense, for my child to return home. I agree
that the terms hereof shall serve as release and assumption of risks for my
heirs, executors, administrators, and all members of my family, including
minors.
PERMISSION
In order for campers to keep in touch with each other, a directory will be
provided to graduates of each camp session. Directories will include student
name, phone number, and email address (if available). During the program,
there may be interviews, photos and video recordings taken of the students.
We hereby give QLN/ SuperCamp permission (without further
consideration) to include the student’s name and contact information in the
camp directory and to take and use statements, photos and video
recordings (if any) for future promotions.
SIGNATURES
I/We have read and understand and agree to all of the terms in this
enrollment package. All information provided by me/us is true and complete
to the best of my/our knowledge. I/We confirm agreement by signing
below:
_______________________________________________________
Student Signature
Date
_______________________________________________________
Print Student Name
_______________________________________________________
KEY /DAMAGE DEPOSIT
Date
A $90 deposit must be submitted to offset charges that may be incurred by Parent Signature
_______________________________________________________
the camper for any damage or lost keys. If damage exceeds $90, you will be
Print Parent Name
responsible for additional costs. Deposits will not be processed unless
expense is incurred.
Camper’s Full Name:__________________________
Date of Birth:________________________________
PHYSICIAN’S HEALTH REPORT (TO BE COMPLETED BY FAMILY PHYSICIAN OR NURSE PRACTITIONER)
Dear Health Care Provider,
The above-named child is planning to spend part of his/her summer at SuperCamp, which is a residential summer program that balances academics with
life skills and daily physical activities. Please complete this form in full to comply with requirements of local, state, and other government authorities. This
camp must and does comply with the American Camp Association guidelines and regulations of associated Departments of Public Health and is licensed
by the local board of health.
Which of the following, if any, has the child had?
Physical Examination
A physical examination within the 12 months prior to attending
SuperCamp is required. If student does not require a full physical
examination, a “wellness check” is recommended.
Date of most recent physical examination:
/
 Measles
 Chicken Pox
 Mumps
 Hepatitis
 German Measles
/
Please list any and all medications including prescriptions, over-the-counter medications, vitamins and/or supplements:
Medication:
Dosage:
Purpose:
Medication:
Dosage:
Purpose:
Medication:
Dosage:
Purpose:
Is the above-named child fit to attend SuperCamp?
 Yes
What physical or mental health limitations does he / she have?
 No
 None
 Has limitations
Please explain and provide all information related to child’s physical restrictions, ongoing treatments, and/or emotional or mental health about which
camp staff should be aware: _________________________________________________________________________________________
_______________________________________________________________________________________________________________________
Immunizations: Please give dates of all immunizations (Attach immunization records if preferred.)
Vaccine
Month/Year
Month/Year
Month/Year
Month/Year
Month/Year
Month/Year
DTP
___________
___________
___________
___________
__________
___________
TD (tetanus/diphtheria)
___________
___________
___________
___________
__________
___________
Tetanus
___________
___________
___________
___________
__________
___________
Polio
___________
___________
___________
___________
__________
___________
MMR
___________
___________
___________
or Measles
___________
___________
or Mumps
___________
___________
or Rubella
___________
___________
HIB
___________
___________
___________
Hepatitis B
___________
___________
___________
Chicken Pox
___________
___________
BCG
___________
TB Mantoux test (recommended)
Date of last test: ___________
Result:
 Positive  Negative
Print Physician/Nurse Practitioner’s name:___________________________________________________________________________________
Physician/Nurse Practitioner’s signature: __________________________________________________________ Date: _____________________
PLEASE FAX OR MAIL TO: SuperCamp, 1938 Avenida del Oro, Oceanside, CA 92056
Telephone: 800-285-3276  760-722-0072  Fax: 760-305-7770  E-mail: [email protected]
Camper’s full name: ______________________________
Camp date: _____________________________________
Best number to confirm travel: (
) ______________
Travel Itinerary
This form must be received in our office in Oceanside, CA, by the date indicated in our cover letter. A completed Travel Itinerary form
is required whether your child is traveling by car or plane to ensure that our staff can make appropriate arrangements for the arrival
and departure of all campers. In addition to this form we require a copy of the official travel itinerary from your chosen airline. This
is to ensure accuracy of flight information.
PLEASE NOTE: Children traveling without a parent or legal guardian are considered to be unaccompanied minors. All airlines have
restrictions regarding ages of children travelling alone and most airlines provide a service to assist these children during their
airline travel. The applicable age restrictions and fees vary so it is vital that you check with airlines regarding their UM program at
the time you make your child’s reservations. See “Travel Arrangements” section of General Information page for additional
information.
ARRIVAL INFORMATION (please check one)
 By Car (campus registration is between 10 a.m. and 12 noon)
Arrival date ______/______/_______
 Attached Original Airline Itinerary
Time _________:_________
 By Plane (arrivals should be scheduled between 9 a.m. and 11 a.m.)
Arrival date ______/______/_______
Time _________:_________
Airline _________________________
Flight #_________________
 Airline-assisted Unaccompanied Minor (see note above)
DEPARTURE INFORMATION (please check one)
 By Car (check-out is between 12 noon and 12:30 p.m.)
 Attached Original Airline Itinerary
Departure Date ______/______/_______ Time _________:__________
Authorized parent or guardian picking up camper: _________________
 By Plane (departures should be scheduled between 3 p.m. and 5 p.m.) * Students with departing flights
scheduled prior to 3PM will likely miss the graduation ceremony to ensure an on time flight departure.
Departure date ______/______/_______ Time _________:_________
Airline ____________________________ Flight #_________________
 Airline-assisted Unaccompanied Minor (see note above)
Shuttle Service: SuperCamp provides courtesy shuttle service for the following airports.
CAMP LOCATION
AIRPORT CODE
AIRPORT NAME
Brown University
PVD
TF Green International
Kent University
CLE
Cleveland Hopkins International
Loyola University Chicago
ORD
Chicago O’Hare International
Loyola Marymount University
LAX
Los Angeles International
Stanford University
SFO
San Francisco International
University of California, Berkeley
OAK
Oakland International
University of California, Los Angeles
LAX
Los Angeles International
University of South Florida
TPA
Tampa International
University of Texas, Dallas
DFW
Dallas - Ft. Worth International
Wake Forest University
GSO
Piedmont Triad International
Shuttle Safety: Please instruct your child regarding the following shuttle safety procedures prior to his/her trip.
1.
2.
3.
4.
Passengers should remain seated at all times with heads, hands, arms and legs inside the vehicle.
Seat belts should be fastened – one person per seat belt.
Noise level should not distract the driver. There should be no throwing of objects or other disruptive behavior.
Passengers should enter and leave the vehicle under the direction of a staff member and/or the driver.
Camper’s Full Name: ________________________________
Medical Release
In the event of serious illness or injury, parents and/or emergency contacts will be called. In the event neither can be reached, I
authorize SuperCamp staff to transport my child to the medical facility designated by SuperCamp for emergency treatment. I hereby
give permission to medical personnel to secure and administer proper treatment, routine tests, hospitalization, x-rays, injections,
surgery, and/or anesthesia and to release any records necessary for insurance purposes for my child. Minor illness or injury, as
determined by SuperCamp wellness person on site, will not result in notification of parents and/or emergency contacts.
I also give permission for medical personnel to administer all stated medication as well as over-the-counter medication provided by
either the family or SuperCamp. I also consent to allow SuperCamp to contact the physician listed on the Student Profile form regarding
any medical/psychological history and/or any medication listed.
________________________________________________________________________
___________________________
Parent/Guardian signature
Date
________________________________________________________________________
Print Parent/Guardian name
Medical Insurance
Photograph
INSURANCE INFORMATION
All students must be covered by medical or travel insurance.
Please complete the information below and provide a photocopy
of the relevant insurance card (front and back).
Insurance company: __________________________________
Group policy number: _________________________________
Insurance company telephone: _________________________
After-hours telephone: ________________________________
Copy of
Medical
Insurance Card
Front
Copy of
Medical
Insurance Card
Back
ATTACH RECENT
PHOTO HERE
Please write
student’s name
on back of photo
Camper's Full Name: __________________________________
Key / Damage Deposit
A key/damage deposit of $90.00 is required for every camper. This deposit will be held as
collateral to offset any charges made by the college or university for lock replacement or
damage to property. We will not process your check or charge your credit card unless an
expense is incurred by your child. Checks not used will be shredded.
Keys: It is important to note that locks are changed by the colleges as soon as it is reported that
a key has been lost in order to protect the property of the occupants and the college. Therefore,
the lost-key charge is applied whether or not the key is subsequently found. This applies during
SuperCamp as well as after camp so please make sure your child's room key is turned in before
you leave the campus after graduation.
Damage: Please note that should damages exceed the $90.00 deposit amount, you will be
responsible for additional costs.
Acknowledgment
I hereby acknowledge my agreement with the foregoing key and damage deposit requirements.
________________________________________________
____________________
Parent/Guardian signature
Date
________________________________________________
Print Parent/Guardian name

CHECK ENCLOSED
(Please make payable to SuperCamp and send original check, not a copy.)
Check number:__________

 USE CARD ON FILE Verify last four digits________ Exp date_______
(Please sign below for authorization to use credit card)
CREDIT CARD
 Visa
 MasterCard
 Discover
 American Express
Card number: __________________________ Security code: ______________
Expiration date: ________________________ ZIP code: __________________
Name on card: ____________________________________________________
Signature: ________________________________________________________
SuperCamp Scholarships Donation Form
Through tax-deductible donations to Learning Forum International, we’ve awarded
SuperCamp scholarships to more than 700 students since 1989, giving them a
brighter future. We welcome your commitment to Making Great Kids
Greater!
“My reading speed went from 234 words per minute to 755 words per minute! You made this life
changing journey, a reality for me!” - excerpt from Tara, a 2011 winner
 YES! I would like to make a donation to the SuperCamp Scholarship
Fund and help send kids to SuperCamp.
Name: _________________________________________________________
Address: _______________________________________________________
City: ____________________________ State: _________ Zip: ___________
Home Telephone: __________________ Work Telephone: _________________
Email: ___________________________ Fax: __________________________
Amount of Tax-Deductible Donation:
 $20
 $50
 $100
 $500
 $1,000
 $_______ (any amount is appreciated)
 $1,500 (half scholarship)
 $3,000 (full scholarship)
Please note that 100% of all donations goes toward SuperCamp tuition costs.
Payment Method:
 Check enclosed (payable to Learning Forum International)
 Charge my credit card:
 Visa
 MasterCard
 Discover
Card number: ___________________________________
Name on card: ___________________ Expiration: _______
Signature: ______________________________________
Thank you!
we appreciate
your support
in providing a
brighter future
for kids.
Learning Forum International is a 501(c) (3) non-profit organization. Donations are tax deductible to the extent allowed by law.
1938 Avenida del Oro, Suite A, Oceanside, CA 92056 • 760-305-7317 • www.learningforum.org • www.8keys.org
FAX: 760-305-7766
Important Camp Information - Please Keep
ARRIVAL DAY
Please ensure that arrival and departure dates coincide with the first and
last day of your child’s camp. Accommodations are not available except
for stated dates.
If driving, please plan to arrive between 10:00 a.m. and noon on the day
camp begins. If flying, the student should arrive at the designated airport
between 9:00 a.m. and 11:00 a.m. on the day camp begins. Students are
met in the baggage claim area by staff members carrying a SuperCamp
sign and wearing a SuperCamp shirt and nametag.
Lunch for students is served from 12:30 p.m. to 1:00 p.m. SuperCamp
begins at 1:30 p.m. with orientation. Since special activities are planned
for students the moment they check in at camp, we request that parents
depart immediately following registration.
DEPARTURE DAY
Parents are welcome and encouraged to attend the SuperCamp
graduation. A reception (coffee and tea) at 9:00 a.m. is followed by a
parent meeting and then graduation, which ends at 12 noon. Students
departing by car should plan to leave campus by 12:30 p.m. Flights
should be arranged to depart from the designated airport between 3:00
p.m. and 5:00 p.m. Students with departing flights scheduled prior to 3
p.m. will likely miss the graduation ceremony to ensure an on time flight
departure. Vans will be arranged to transport students from SuperCamp
locations to designated airports for departing flights.
TELEPHONE CALLS / VISITS
We cannot maximize the effectiveness of the program if the student’s
experience is interrupted by visits, excessive phone calls, or removal
from camp. It is requested that calls to campus and departures from
campus be made only for emergencies. Prior to camp you will receive the
campus mailing address and telephone number. If you need to leave a
message for your child, the on-site office hours are 8:00 a.m. to 8:00 p.m.
(camp time zone).
Students may bring a cell phone which must be checked in on arrival and
can be checked out for calls on certain days for a limited time. The time
of day will vary depending on the camp session. If a student fails to turn
in his/her cell phone and it is found in his/her possession, the student
will lose their cell phone privileges for the duration of camp.
OUTDOOR ADVENTURE DAY
We use professional and experienced companies to set up and safely
assist students through all Outdoor Adventure events. Individual physical
needs are considered. Participation in this activity is encouraged, but not
required.
ACADEMIC AND LIFE SKILLS CURRICULUM
Course room times vary by subject. Students may be in the course rooms
for six hours or more a day. The curriculum is highly interactive with
breaks scheduled throughout the day. We reserve the right to alter or
cancel any course advertised if such action is deemed necessary to
improve the camp’s overall effectiveness.
EVALUATIONS
We maintain a non-competitive environment where students measure
their own success based on personal progress during camp. A selfassessment form is provided to each student at the Junior and Senior
Forum levels. The self-assessment form is mailed to parents by the end
of September. Elective credit is given by some schools for participation in
SuperCamp’s Senior Forum. Certificates are mailed in September with
the self-assessments forms.
IN CASE OF EMERGENCY
Please provide appropriate telephone numbers in the Emergency Contacts
section of the Confidential Student Profile form so that we are able to
reach parents or designated emergency contacts both day and night.
Please also include your child’s cell phone number (phone to be used while
traveling) in the Household Information section of the Confidential
Student Profile form.
REQUIRED FORMS
Confidential Student Profile
Please be sure to answer all questions completely and provide any additional
information that may enhance our ability to ensure that your child’s SuperCamp
experience is positive.
Agreements
Both parent and student signatures are required on the Agreement form. In the
event that you are unable to obtain your child’s signature prior to returning this
form, please make a copy of the agreement form, have your child sign it ASAP and
send it to our office in Oceanside, CA, prior to the first day of camp.
Physician’s Health Report
Have your child’s physician or nurse practitioner fill in all requested information,
including a complete record of all immunizations. Note: All medication must be
checked in with the Wellness Person at registration (including over-the-counter
medications, vitamins and supplements). Inhalers, EpiPens, and birth control pills
do not have to be turned in.
Travel Itinerary
Please complete this form whether your child is traveling by car or plane and
return it to our office in Oceanside, CA, as soon as travel plans have been
finalized. Should travel plans change after submitting the Travel Itinerary form,
please contact our office immediately at 800-285-3276 or email us at
[email protected]. In addition to this form, please submit a copy of
your official airline itinerary to ensure accuracy of flight information.
Medical Release
Sign the medical release form and include a copy of your medical insurance card
(front and back) or a copy of your child’s temporary travel insurance coverage.
Attach a current photo of your child to this form.
Key/Damage Deposit
A $90 key/damage deposit is required for every camper. Please sign the form and
provide us with credit card information or mail us a check (original, not copy)
which will be held securely by SuperCamp. Parents will be notified of any lost key
or damage report by October. If keys are returned by the last day of camp and no
damage is reported, check or credit card information will be shredded.
TUITION
Tuition must be paid in full by May 1, 2013 unless prior arrangements have been
made with our Oceanside office. If final payment is not received by this date, you
could forfeit your child's place in the SuperCamp program and be subject to our
cancellation fees.
TRAVEL ARRANGEMENTS
Traveling Alone: Campers traveling alone will be met at baggage claim by our
SuperCamp staff who will be wearing SuperCamp T-shirts and carrying ID.
Unaccompanied Minor: If your child is flying as an unaccompanied minor
registered for assistance by an airline, an additional fee is required by the airline.
Please check with your airline regarding age guidelines, restrictions, and fees. For
security, the airline requires SuperCamp staff to show a photo ID and obtain a
security pass in order to pick up your child in a secured area. Please see Travel
Itinerary form.
Baggage Fees
Please check with your airline regarding baggage fees and prepay options. If
possible, prepay baggage fees for your child's return trip. Otherwise, make sure
your child has the cash required for baggage fees. Any baggage fees paid by
SuperCamp staff will be billed to you.
Airports
SuperCamp provides courtesy shuttle service on arrival and departure days to
and from designated airports only. Please check the airport for your child’s camp
location on the Travel Itinerary form before making any flight reservations
SUPPLIES
All students receive a SuperCamp “playbook,” pens, and all course materials.
The playbook contains valuable information useful for review after camp and
during the school year.
Suggested Packing List – Please Keep
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shorts for each day
short-sleeve shirts for each day
underwear for each day + extra
socks for each day + extra
2 pairs of long pants
2 long-sleeve shirts
sweatshirt
wind jacket
sneakers
(dresses or skirts not recommended)
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sandals
flip-flops for shower
2 pairs of pajamas
bathrobe
ear plugs (if needed for sleeping)
toothpaste, shampoo, soap,
deodorant, etc.
cell phone and charger
non-perishable snacks
reusable water bottle
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sunglasses
medication(s) (in original Rx containers)
sunscreen/lip balm
small fan (dorms may not be air
conditioned)
bug spray
$30 for misc. expenses such as
campus book store purchases or
airport snacks
$40 for return flight baggage fee
PLEASE NOTE: SuperCamp is not responsible for lost or stolen personal property. We suggest all personal items be labeled.
All labeled lost and found items will be mailed to the camper’s US home address following graduation. Int’l items will not
be mailed. Unlabeled lost and found items will be donated to a local charity 48 hours after camp has ended.
What to Leave at Home
We are able to achieve our results by providing a safe, focused and engaging environment, free of distractions. For this
reason, all audio/visual devices such as music players, TVs, stereos, iPads, laptops, etc., and all sports equipment,
skateboards, rollerblades, scooters, etc., should be left at home. If students arrive with any of the above items, or if they are
found in someone’s possession during camp, they will be taken and stored in the SuperCamp office for the duration of the
program. It is the camper’s responsibility to retrieve these items from the office immediately following graduation. Please
leave all valuables at home. No animals allowed.
Dormitory Information
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Housing is in furnished college dormitories.
Students are housed two to four per room depending
on the campus.
Bathrooms are either shared by students in two
rooms or students may share a hall bathroom.
Basic linens and towels are provided.
Most dormitories are not air conditioned.
Most course rooms are air conditioned.
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Team Leaders help supervise the students and
are assigned to the same dormitories.
Male and female students and Team Leaders are
housed in separate areas of the dormitories.
No laundry facilities are available.
Depending on the site, temperatures can range
from 70°–95° during the day and 60°–80° at
night.
Communication
We understand that you are interested in what your child is doing. We provide photos of your child’s session that you can
view online every day. To view photos, follow the instructions to the secured photo website provided in your parent letter.
This important letter will be emailed to you approximately two weeks prior to your child’s camp start date and will include
information regarding communication with the camp site staff.
Cell phones brought to camp must be turned in during registration. Cell phones may be checked out on certain days for a
limited time. The time of day will vary depending on the camp session. If a student fails to turn in his/her cell phone and it
is found in his/her possession, the student will lose their cell phone privileges for the duration of camp.
Although we allow students to make phone calls, we encourage them to limit their phone usage as we find that it distracts
them from being fully engaged in the program. Just like you, we want your child to get the most out of his/her SuperCamp
experience. Please help us by doing your part in following these guidelines and we will do our part to make your child’s camp
experience as valuable as possible.