enrollment documents

ENROLLMENT DOCUMENTS
The following forms need to be completed before your son can be enrolled:
•
Packing List (3 pages)
•
UHSAA Hardship Waiver Request (3 pages)
•
UHSAA Sports Consent and Pre-Participation Physical Evaluation (2 pages)
•
Interstate Compact (2 pages)
Please send, fax, or email the above documents to:
Telos Residential Treatment
870 West Center
Orem, UT 84057
Fax: 801-426-8825
Email: [email protected]
or
[email protected]
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Telos Packing List
Dear Parents:
This is a detailed list of everything your son will need while at Telos. Your son will need all the items on the
required list. Those items that you do not have, or do not want to send, will be purchased by our staff out of
the money you deposit into the trust account. Receipts and documentation will be provided for all purchases.
We do not consider it to be an inconvenience to shop with your son after admission. It gives us an
informal chance to interact with him. Also, we have bulk buying power to purchase items at a significant
discount. We especially discourage you from purchasing a bike for your son; we can get quality discounted
bikes here, and it is very important that the fit be appropriate.
Please do not send anything that is not included on this list. Items that are not acceptable will be shipped back
to you at your expense. Telos does not have room in the facility to store contraband items.
Also, please label your son’s personal belongings (especially musical instruments) before sending them. We
will label them here if they arrive without any labeling.
Required items:
Items listed in the application for admission
• Completed application (online)
• Copies of prior testing/assessment
• Family physician contact information
• Immunization record
• List of current medications
• Medical insurance card
• Dental insurance card
Regular clothing
• Two pair comfortable shoes
• One collared dress shirt
• Eight shirts; these must not have any printed material that is inappropriate (music groups, sexual,
derogatory, etc). These can be t-shirts, long sleeve, collared, etc.
• Six pairs of conservative denim jeans or knee-length shorts
• Two pair pajamas
• Winter coat (fall to spring)
• Light jacket
• One hoodie
• Ten pairs of socks and underwear
• A conservative belt
• Shower sandals
• One casual sandal (Flip Flops, Chaco, Teeva, etc)
Other
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Electric razor
Swim trunks
Journal (any size)
Two bath towels
Two wash cloths
One set twin sheets with pillowcase
One comforter
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One or two pillows
One mattress pad
Optional seasonal items
• Two hats or beanies
• One pair of snow gloves
• One pair snow pants
• One snow appropriate footwear
• One snowboard/ski boots
• Either skis or snowboard allowed—only one please
• Snowboard/ski helmet
• One pair ski goggles
• One skateboard/longboard with wrist guards and helmet (required)
Other optional items:
• Blanket
• Musical instruments
• Religious books
• Contacts/eyeglasses/sunglasses
• Pictures of family members or approved friends
• One conservative bracelet, necklace, and/or ring
• Personal hygiene items (non-aerosol)*
• Cheap waterproof sports watch
Banned items:
• All items not included above
• Personal money
• Cell phones
• Earrings
• Any clothing that brings undo attention, is ragged, or in anyway affiliated with subculture: drug, music,
anarchy themes, etc.
• Straight razors
• Pocketknives or other weapons
• Computer games
• Headsets or personal radios/iPods
• Glass items
• Aerosol items (deodorants, colognes, etc.)
*Telos provides all hygiene related items like deodorant, soap, toothbrush, shampoo, laundry detergent, etc.
Triathlon Equipment
Below you will find the triathlon equipment your son will need during his stay at Telos. Shopping for athletic
equipment can be frustrating and expensive. We are happy to take care of all equipment purchases through
our “in house” Triathlon shop. Unless you request otherwise, we will charge all required items to your son’s
trust account. If you are not interested in having Telos manage the acquisition of your son’s gear, please let
the admissions team know.
T3TRI is our in-house triathlon shop. We keep all the latest triathlon gear in stock. Knowledgeable coaches
help equip new students with appropriate gear. Our vendors include Saucony, Zoot, Louis Garneau, Fuji,
KHS, TFOSI, Finis, Neosport and others. We pass along discounts on all apparel, accessories, and bikes to
students/families, and employees.
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T3TRI proceeds pay for coaching services, students annual fitness center passes, student race registration
fees, and elite team activities.
Triathlon equipment list
Swim (required)
• Goggles
• Quality Jammers (chlorine resistant)
• Swim cap
• Paddles/fins
• Wetsuit
Bike (required)
• Biking gloves
• Quality running/biking pants (ankle zipper non-cotton)
• Quality triathlon shorts (quick dry with pad)
• Triathlon jersey
• Quality road bike
• Flashing safety light
• Quality bike helmet
• 2 water bottles
• Water bottle cage
• Bike tool & flat tire repair kit
• 2 spare tubes
• Saddle bag
• Pedals
• Reflector vest
• Ankle reflectors
Run (required)
• 3 pair running/biking socks (coolmax)
• Quality running shoes
Optional upgrades
• Bike upgrade
• Clipless pedals and shoes
• Camelback
• Ear plugs
• Nose plugs
• Tifosi sunglasses
• Visor
• Handheld water bottle
• Yanks shoe laces
The estimated amount for all required triathlon gear is $1,800-$1,975.
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UHSAA TRANSFER FORM
Telos is a member of the Utah High School Activities Association. This means even though we are a
private treatment program, your son will have the opportunity to participate in a legitimate high school
sports program (separate from our triathlon training program), competing with other public and private
high schools in the region. There are rules and guidelines governing player transfer and eligibility.
For your son to participate on a team, he will need to prove eligibility in Utah, which requires you to fill
out the following Hardship Waiver Request. The eligibility verification process can take up to 2
months, so fill out these forms even if you don’t think your son will be interested in the sports program
at Telos. Many Telos students change their mind last minute and want to participate.
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Complete this portion
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Complete this portion
Complete this portion
Placement)in)a)private)treatment)program)for)youth)in)Utah.)
Telos)Academy)
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))))Kristin)Williams)
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Complete this portion
This)form)certifies)that)you)have)received)and)read)the)information)above)on)concussions.)
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Complete this portion
Please fill out highlighted areas and return to Telos with your enrollment documents.
UTAH
Complete this portion
X
X
TELOS RESIDENTIAL TREATMENT
870 WEST CENTER, OREM, UT 84057
801-426-8800
X X
✔
Complete
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UTAH
Complete
X
TELOS
870 WEST CENTER, OREM, UT 84057
RESIDENTIAL TREATMENT CENTER
Complete
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