Camp Frog - Epilepsy Foundation of Western/Central Pennsylvania

CAMP CONRAD WEISER
Guardian’s Name:
Guardian’s Name:
Child’s Name:
Child’s Name:
Child’s Age as of June 1, 2016:
Child’s Age as of June 1, 2016:
Last Grade Completed as of June 1, 2016:
Last Grade Completed as of June 1, 2016:
Address:
Address:
City, State, Zip:
City, State, Zip:
Phone:
Phone:
Email:
Email:
PAID
CAMP FITCH
Pittsburgh, PA
Permit No. 1390
PRE-REGISTRATION FORM FOR
Non-Profit Org.
U.S. Postage
PRE-REGISTRATION FORM FOR
p
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2016
C rog
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A summer camp for
children and teens
who have seizures
Has your child attended Camp Frog or
Teen Getaway before?
■ YES ■ NO
Has your child attended Camp Frog or
Teen Getaway before?
■ YES ■ NO
SESSION FEE:
Session Fee: $630
Price includes a mandatory insurance fee. Financial Assistance is
available through the Steve “Froggy” Morris/G. Peter Rockwell
Endowment Fund. Some camp activities including but not limited
to horseback riding, crafts, shooting activities, and others are
offered at an additional fee not included in the camp tuition.
$485
age 8
$700
ages 9 & up
Contact Gretchen Knaub at 1-800-336-0301 or
[email protected] for details.
A $30 non-refundable deposit is requested to confirm your
child’s registration. Please detach this form and return it to the
EFWCP office along with payment by check, credit card or
money order made out to EFWCP by April 15, 2016.
Cash payments are not accepted.
All registration information MUST be finalized by May 20, 2016.
Mail To:
EFWCP
Attn: Amanda Stein
1501 Reedsdale Street, Suite 3002
Pittsburgh, PA 15233
Mail To:
EFWCP
Attn: Gretchen Knaub
3507 Market Street, Suite 203
Camp Hill, PA 17011
✁
A $30 non-refundable deposit is requested to confirm your
child’s registration. Please detach this form and return it to the
EFWCP office along with payment by check, credit card or
money order made out to EFWCP by May 2, 2016.
Cash payments are not accepted.
All registration information MUST be finalized by June 3, 2016.
Pittsburgh, PA 15233
Contact Amanda Stein at 1-800-361-5885 or
[email protected] for details.
1501 Reedsdale Street, Suite 3002
Price includes a mandatory insurance fee. Financial Assistance is
available through the Steve “Froggy” Morris/G. Peter Rockwell
Endowment Fund. Some camp activities including but not limited
to horseback riding, sailing, kayaking, and canoeing are offered
at an additional fee not included in the camp tuition.
Camp Conrad Weiser
June 19-25, 2016 • Wernersville, PA
Camp Fitch
July 10-16, 2016 • North Springfield, PA
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2016
Camp Frog is a nationally-recognized program
that places extra supportive and medical
services into existing YMCA summer camp
programs, allowing children who have seizures
to enjoy summer camp just like their peers.
The EFWCP provides counselors in the
cabins along with the camp program staff.
All of the camp staff is fully trained by the
EFWCP. Our counselors will help to provide
seizure recognition and first aid, build
confidence, and provide guidance to
campers in a fun-filled atmosphere.
In addition, a pediatric neurologist and a
nurse will be available on-site during the
entire week of camp. This medical staff
supervises medication administration and
any seizure-related medical care required by
our campers.
Families that can not afford to pay camp fees
can apply for a G. Peter Rockwell Camper
Scholarship made available under the
Steve “Froggy” Morris/G. Peter Rockwell
Endowment Fund. Partial and full
scholarships are available for payment
of camp fees.
Eligibility
Camp Frog at
Camp Conrad Weiser
June 19-25, 2016
Wernersville, PA
Contact Person: Gretchen Knaub
Medical Staff: WellSpan Neurosciences
Camp Conrad Weiser is a YMCA camp located on a
scenic mountaintop in eastern PA near Reading.
Camp Frog at
Camp Fitch
July 10-16, 2016
North Springfield, PA
Contact Person: Amanda Stein
Medical Staff: Children’s Hospital of Pittsburgh
Camp Fitch is a YMCA camp on 450 acres along the
shores of Lake Erie.
The camp offers a wide range of program areas,
including two athletic fields, archery and riflery ranges,
tennis courts, basketball and volleyball courts, a nature
center, an auditorium/program center, campfire rings,
craft shop, a large outdoor swimming pool facility,
climbing tower, ropes courses, and a riding stable with
miles of trails. Sailing, canoeing and kayaking are also
offered at the nearby Blue Marsh Lake.
An array of activities are offered to the campers
including archery, horseback riding, climbing towers,
sand volleyball, basketball, soccer, paintball, riflery, miles
of hiking trails, nature studies, arts and crafts, fishing and
much more. Camp Fitch also has an inland lake for
boating, an Olympic size swimming pool and a mile of
the sandy Lake Erie beach.
For more information on Camp Conrad Weiser, visit
www.smymca.org or call 610-670-2267.
For more information on Camp Fitch, visit
www.campfitch.com or call 330-744-8411.
The Epilepsy Foundation Western/Central PA
invites children and teens between the ages of 8
and 17 years old (having completed 3rd grade
but not yet graduated high school) who have a
primary diagnosis of epilepsy or seizure disorder
to attend Camp Frog 2016! The EFWCP strives
to make a camping experience available to all
children with epilepsy; however, campers must
meet all basic eligibility criteria.
The health and safety of all campers is our
number one priority. Camp Frog is a fully
integrated camp program. Campers need to
have the skills to function independently within
an inclusionary setting at all times. They need to
possess the ability to participate and function
within both small and large groups, without oneon-one assistance or supervision. Independent
self-care skills are required. This includes but is
not limited to independent toileting, bathing,
communication and feeding skills.
All campers must complete a Camp Frog
registration packet and new campers must
meet with an EFWCP staff member in person
before the registration process is complete.
Final acceptance and confirmation of eligibility
for Camp Frog is determined through a medical
review of the camper’s application by both the
camper’s personal physicians and the medical
staff supervising Camp Frog.
The EFWCP encourages participation by
everyone. If your child has any special needs—
physical or behavioral—please contact us as
soon as possible to discuss eligibility at
1-800-361-5885. We will work with your family
and the private camping facilities to explore
potential accommodations of your child’s
special needs. Children who may need
specific accommodations must be fully
registered for camp and accommodations
must be confirmed at least one month prior to
the start of camp. Please register early and
contact the EFWCP staff if you need to discuss
accommodations.