Aloha Camp Timberline Ohana!

Fun’s up this summer!

Camp Timberline Hawaii is the premier adventure camp program of Kama’aina Kids geared specifical-ly for youth ages 9-17. Participants are about to take a right of passage that will be an unforgettableexperience. Whether going away from home for the first time, catching their first ride, creating greatfriendships, working as a team, honing life skills or recognizing the strength of oneself, this experienceis bound to change the life of your child!

Our programs, in keeping with the mission of Kama’aina Kids, fosters an enhancement of Self,Community and the Earth. This takes place through involved experiential processes that turn learningabout the planet into actions that reinforce proper care of the Earth. In essence, through sharedexperiences, campers grow stronger as individuals.

The accompanying parent packet contains everything you need to get ready for your child’s adventurein Hawaii, including the Information Registration Form, Date and Payment Form, Health Waiver,Parent & Camper Contract, Parent Info Sheet, Camp Gear List, and a map of Camp Timberline’s facil-ities.

If you haven’t yet, and you wish to sign up your child to our outstanding accredited camp, please fillout the Registration Form, Health Waiver and Parent & Camper Contract and mail it back to: CampTimberline Hawaii c/o Heeia State Park, 46-465 Kamehameha Hwy, Kaneohe, Hawaii 96744. TheParent Information Sheet, Camp Gear List and Activities Calendars are informational sheets for you to keep as you prepare for camp.

SUMMER CAMPERS DON’T FORGET!!!Please include your 50% tuition payment, which is due when registering, and the balance of paymentis due by June 9, 2014.

We are sure to have some exciting Camp adventures and we very much look forward to meeting our campers this season! If you have any questions or concerns, please contact us at 808-235-6509 or by email at info@kamaainareservations.com.

Hoi Ho’omoana (Happy Camping),

Alvin LawrenceCamp Timberline Programs Director

Residential Camp Programs46-465 Kamehameha Hwy • Kaneohe, Hawaii 96744Phone: 808-235-6509 • Fax: 808-235-6519Email: info@kamaainareservations.comwww.kamaainakids.com

Rev.4/15/14

SUMMER 2014Session 1: June 15 - June 20Session 2: June 23 - July 27

Registration Deadline: June 9 2014

(SUMMER SESSIONS)CAMP TIMBERLINE 1 2 Received on _____________ Entered on _____________

1. Child’s Name (last, first, m.i.) ___________________________________________________ Grade_______ Age_______ Sex_______

Birthdate______________________ School Attending _________________________________________ Shirt Size_________________

2. Parents / Legal Guardians (AUTHORIZED TO PICK UP CHILD)

Father____________________________________ DrLic#___________________ Work Ph. ______________ Home Ph. ______________

Mother____________________________________ DrLic#___________________ Work Ph. ______________ Home Ph. ______________

3. Mailing Address________________________________________________ City______________________ State______ Zip___________

4. Medical Conditions/Allergies_________________________________________________________________________________________

5. Doctor’s Name_____________________________________________________ Phone__________________

Address___________________________________________ City__________________________ State_______ Zip_______________

6. Medical Insurance__________________________________________________ Policy #_______________________________________

7. Authorized Pick-Up & Emergency People (Other than parents / legal guardians):

a. Name_________________________________ DrLic#___________________ Work Ph. ______________ Home Ph. ______________

b. Name_________________________________ DrLic#___________________ Work Ph. ______________ Home Ph. ______________------------------ SPONSOR ------------------

I hereby give consent to the Camp Timberline and Kama’aina Kids staff that is caring for my child--while they are at camp or on off-island trips--to care for my child andmake decisions in the best interest of my child, while they are away from my custody. I understand that the staff will first attempt to contact me and consult with mebefore making any decisions. I hereby agree that, if Camp Timberline or Kama’aina Kids is unable to contact me or one of the persons listed as an emergency contact,that at the discretion of the Camp Timberline or Kama’aina Kids supervisor on duty, I consent that if my child exhibits signs of illness or injury, my child may be taken tothe nearest medical facility and be given any examination that is deemed necessary by the personnel of the medical facility and, if permissible by medical facility, subse-quently released to Kama‘aina Kids Supervisor or staff-in-charge. I also agree to pay for any and all out-of-pocket medical/dental expenses for my child that is not cov-ered by my child’s medical/dental insurance plans.I hereby give my child permission to attend and participate in the activities conducted by Kama`aina Kids’ program. These activities include aquatics, off-property excur-sions, van transportation, and enrichment activities. I hereby authorize Kama`aina Kids to use my child’s name and video or photograph at any time and in any manner in connection with its advertising, publicity, and public relations programs. The video-photo may only be used by Kama`aina Kids. No further claims will be made by me.

------------------ PAYMENT / REFUND POLICY ------------------Payment: A NON-REFUNDABLE 50% DEPOSIT PER CAMPER IS DUE UPON REGISTRATION; THE REMAINING 50% BALANCE IS DUE BY JUNE 9th.Refund/Withdrawals: No credits or refunds will be given for missed or absent days. If you decide not to attend camp for any reason, you will forfeit your 50% non-refundable deposit. Once your camper has arrived at camp there will be NO REFUND of camp tuition. Campers dismissed or removed from the camp for any reason will receive no refunds. Parents are responsible for any costs incurred to send a camper home early.

------------------ RISK WAIVER ------------------I hereby give my child permission to attend and participate in the activities conducted by Camp Timberline and Kama’aina Kids. I am aware of the inherent risk of injury,death and/or property damage in program, camping and trip activities, including but not limited to hiking, swimming, surfing, ropes courses, transportation (by van, bus & airplane), off-site excursions, and other ocean and adventure activities. I hereby acknowledge the risk and danger and certify that my child(ren) is/are physically andmentally capable of participating in the programs offered by Camp Timberline and Kama’aina Kids.

I agree to hold the employees and management of Camp Timberline and Kama’aina Kids harmless in such an event, whether on or off the premises, except to the extentsuch injury, death or property damage is caused by the gross negligence or willful misconduct of such employees or management.

I hereby agree to the policies above and authorize Camp Timberline and Kama’aina Kids and its employees to exercise the above stated policies in regards to my child.

Signature of Releasor ______________________________________________________ Date ____________________*Please return all copies 46-465 Kamehameha Hwy • Kaneohe, HI 96744

How did you hear about us? Staff Name: ___________________ q Flyer q Brochure q Internet q Email q A Friend

Would you like to be informed of company-wide events and news by email?

q No q Yes, EMAIL address (print clearly): ____________________________________________ q I am on email list already

CAMP TIMBERLINE SUMMER 2014Information/Registration Form REGISTRATION DEADLINE: SUMMER IS JUNE 9, 2014. Late registration fee (after deadline): $25

Rev.4/15/14 OVER

FOR OFFICE USE ONLY

CONTACT: CT HAWAII c/o HEEIA STATE PARK46-465 KAMEHAMEHA HWY, KANEOHE, HAWAII 96744

PHONE: (808) 235-6509 • FAX: (808) 261-2051EMAIL: info@kamaainareservations.com

Please check the appropriate box(es) for your session choices below:

1 SUMMER PROGRAMS 2014, Ages 9-17 TuitionCosts include lodging, food, transportation, excursions, and curriculum.

q Pirate Week 1 - June 15-June 20 (6 days, 5 nights) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$800

q Fun Factor - June 23- June 27 (5 days, 4 nights) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .$600

Rev.4/15/14

q CASH q CHECK q MONEY ORDER

q VISA q MASTERCARD q DISCOVER q AMEX

Name on card: ____________________________________ Card #: ______________________________

Expiration Date: _____________________ Amount to charge: $_________________

Signature ___________________________________ Date ____________________

FOR SUMMER: 50% BALANCE OF PAYMENT DUE BY JUNE 9, 2014Please check ONE of the following

q Charge balance owed to the same credit card listed above on June 1, 2013.

q I will mail in the balance owed by June 9, 2014 as a check or money order.

q I will call 808-235-6509 to authorize a charge of the balance owed to a new/different credit card by June 9, 2014.

Make checks payable to: CAMP TIMBERLINE

Mail registration & payment to:Camp Timberlinec/o Heeia State Park

46-465 Kamehameha HwyKaneohe, Hawaii 96744

PAYMENT

SURF CAMP PROGRAM DISCOUNTS

MULTIPLE SIBLINGS DISCOUNT:1. ONE TIME $50 FAMILY DISCOUNT FOR SIGNING UP

MULTIPLE SIBLINGS IN ANY SURF CAMP SESSION.

VETERAN SURF CAMP DISCOUNT:1. ONE TIME $50 DISCOUNT FOR REPEAT OR

RETURNING SURF CAMP CAMPERS.

SURF CAMP GROUP DISCOUNT:1. SIGN UP A GROUP OF 10 OR MORE SURF CAMPERS

IN ONE SESSION AND RECEIVE A 10% OFF GROUP DISCOUNT.

EARLY REGISTRATION:1. SIGN UP BEFORE MAY 20TH AND RECEIVE $100

SAVINGS

***Maximum discount any one family or group can receive is no more than 20% off the total program costs.

CAMP TIMBERLINE SUMMER 2014

Dates and PaymentREGISTRATION DEADLINE: JUNE 9, 2014. Late registration fee (after deadline): $25

TOTAL PROGRAM COSTS $________________

# of TuitionCampers Cost

_____ X $25 = (-) $____________

. . . . . . . . . . = (-) $____________

. . . . . . . . . . = (-) $____________

. . . . . . . . . . = (-) $____________

. . . . . . . . . . = (+) $____________

Subtotal 1 = $____________

CAMP TOTAL = $____________

50% DUE NOW $____________

Amount Rec’d $____________

Date_________

$____________

Amount Rec’d $____________

Date_________

(x) (=) TOTAL

Multiple Sibling Discount(Flat $25 off for families registering with a sibling)

Late Registration Fee $25(If after June 1 for Summer)

Early Bird 10% Discount(Effective till May 25th 2014)

Subtotal 1 = (Total minus any Discounts, plus Late Fee)

BALANCE DUEJune 9, 2014

____ x $800 = ____________ x $600 = ________

Rev.4/15/14

Health WaiverPlease complete this form and RETURN along with your registration.DO NOT FORGET THIS FORM AS YOUR CHILD WILL NOT BE ABLE TO JOIN US UNLESS THIS FORM IS TURNED IN!

Child’s Name ____________________________________________________________________________________________

Home address, city, zip ____________________________________________________________________________________

Birthdate__________________ Age______ Grade______ Male______ Female______ Height______ Weight______

Mother’s/Legal Guardian’s Name ____________________________________ Phone (H) _______________ (W)______________

Father’s/Legal Guardian’s Name ____________________________________ Phone (H) _______________ (W)______________

Emergency Contact Person (Other than parent/guardian) __________________________________________________________

Relationship___________________________________ Phone (H) _____________________ (W) ______________________

Medical Insurance ___________________ Policy # _________________ I will inform the director if the coverage is changed.

Doctor’s Name ________________________ Address ___________________________________ Phone # __________________

My child is permitted to swim under the supervision of a certified lifeguard Yes _______ No _______

My child is a vegetarian Yes _______ No _______

Please attach an extra form if you need additional writing space.1. List any limitations that may hinder your child’s participation in the various camp activities:2. List special requirements or conditions - i.e., special medication, diet, etc.:3. Allergies, if any, such as food, insect bites, flowers:4. List any unusual fears, such as fear of water or darkness:5. List any special considerations - i.e. does child sleep walk? bed wet?6. Please list or explain any other personality traits which may be helpful for the staff to know:

Residential Camp Programs46-465 Kamehameha Hwy • Kaneohe, Hawaii 96744Phone: 808-235-6509 • Fax: 808-235-6519Email: info@kamaainareservations.comwww.kamaainakids.com

This health history is correct so far as I know, and the person herein described has permission to engage in all prescribed camp activities except as noted. Authorizationfor Treatment: I hereby give permission to the medical personnel selected by the camp director to order X-rays, routine tests, treatment, and necessary related transportation for my child. In the event I cannot be reached in an emergency I hereby give permission to the physician selected by the camp director to secure andadminister treatment, including hospitalization, for the person named above. The completed forms may be photocopied for trips out of camp.

If for religious reasons you cannot sign this, please contact Kama`aina Kids at (808) 262-4538 for a legal waiver which must be signed for attendance.

_______________________________________________________ __________________Signature of Parent or Guardian Date

Parent & Camper ContractPlease complete this form and RETURN along with your registration.DO NOT FORGET THIS FORM AS YOUR CHILD WILL NOT BE ABLE TO JOIN US UNLESS THIS FORM IS TURNED IN!

PLEASE READ THE FOLLOWING SHEET. BOTH PARENT & CAMPER MUST SIGN THE STATEMENT BELOW. Note: Your signature means that both camper and parent understand the payment/refund policies, risk waiver, behavior guidelines & consequences and agree to follow them.

Payment & Refund PolicyPayment: A NON-REFUNDABLE 50% DEPOSIT PER CAMPER IS DUE UPON REGISTRATION; THE REMAINING 50% BALANCEIS DUE BY JUNE 9. Refund/Withdrawals: No credits or refunds will be given for missed or absent days. If you decide not to attendcamp for any reason, you will forfeit your 50% non-refundable deposit. Once your camper has arrived at camp there will be NO REFUND of camp tuition. Campers dismissed or removed from the camp for any reason will receive no refunds. Parents areresponsible for any costs incurred to send a camper home early.

Risk WaiverI hereby give my child permission to attend and participate in the activities conducted by Camp Timberline and Kama’aina Kids. I am aware of the inherent risk of injury, death and/or property damage in program, camping and trip activities, including but not limited to hiking, swimming, surfing, ropes courses, transportation (by van, bus & airplane), off-site excursions, and other ocean and adventure activities. I hereby acknowledge the risk and danger and certify that my child(ren) is/are physically and mentally capable of participating in the programs offered by Camp Timberline and Kama’aina Kids.

I agree to hold the employees and management of Camp Timberline and Kama’aina Kids harmless in such an event, whether on or off the premises, except to the extent such injury, death or property damage is caused by the gross negligence or willful misconduct of such employees or management.

Camper Behavior ContractCamp Timberline provides a safe and accepting community that fosters growth and caring respect for oneself, others and the environ-ment. Each parent and camper’s cooperation is needed to build a camp community where people feel safe to venture out, learn newthings and meet new people. Campers who cannot adhere to these guidelines should not attend camp.

Camp Timberline Rules, Guidelines & Consequences 1. Bring a GREAT ATTTUDE to camp. A positive attitude is a must and campers need to be willing to participate and have fun!2. Listen to ALL Camp Counselors & follow directions.3. Think before you act: Is it safe? Will it hurt someone’s feelings? Will it affect the environment?4. Respect other people AND their property.5. Stay within camp boundaries.6. Respect quiet hours 10:00 pm – 7:00 am.7. No girls in or near boy’s cabins, no boys in or near girl’s cabins.8. Never intentionally harm another person physically or emotionally. Violence, fighting, foul or racist language,

name-calling and threats are not permitted!9. We encourage a friendship and family like camp community. “Couples”, holding hands, kissing or any type of

physical contact is not permitted and will result in immediate dismissal from camp, forfeiting all tuition fees.10. Smoking, alcohol, drugs and weapons are not permitted or tolerated and will result in immediate dismissal from

camp, forfeiting all tuition fees.11. During quiet hours, overnight, everyone should be in their cabins. The only reason to be out of your cabin is to use the

bathroom or to see a counselor if there is an emergency. If this rule is not followed, it will result in immediate dismissal from camp, forfeiting all tuition fees.

ANY CAMPER WHO DOES NOT FOLLOW THE ABOVE GUIDELINES:1. Will be dismissed from camp. If on the trip, after a phone consultation w/the parent/guardian, will be sent home.2. Will NOT be refunded camp fees.3. Risks losing the privilege of returning to camp in the future.4. Parent/guardian will arrange and pay for their transportation home (even while on the trip).

I have read, understand and agree to follow all of the above guidelines and policies:

Camper Signature______________________________________ Date_______________

I, as parent or guardian of my child(ren), acknowledge that I have read this agreement carefully and understand its contents.I also acknowledge that Kama’aina Kids is materially relying on this contract in allowing my child(ren) to engage in any or all trip activities.

Parent Signature_______________________________________ Date_______________

Rev.4/15/14

Residential Camp Programs46-465 Kamehameha Hwy • Kaneohe, Hawaii 96744Phone: 808-235-6509 • Fax: 808-235-6519Email: info@kamaainareservations.comwww.kamaainakids.com

Parent Information SheetCAMP TIMBERLINEIf arriving by plane, you will be met at the baggage claim. Please schedule, or ask your travel agent to schedule, arrival anddeparture times between 9am and 2pm. If arriving by car, arrive between 2pm and 3pm or call toll-free at 1-877-672-4386.

Please email us your teen’s flight details by June 9 to ensure proper scheduling and pick up at the airport. Include your teen’s full name, airline, flight number and arrival time. Your child will call you once they’ve arrived safely. Email us at:info@kamaainareservations.com.

Cost includes overnight lodging at Camp Timberline, food, transportation, activities & excursions, and camp specific curricu-lum for the entire session.

All other details, information and activity schedules can be accessed at http://www.kamaainakids.com/residential-summer-camps.

Transportation:Camp Timberline travels in 15-passenger vans or scheduled bus. Campers will be expected to wear their seatbelts at all times andfollow all van/bus rules to ensure safety during transport.

Medication:If your child needs to take medication, please request an “Authorization to Dispense Medication Form” from our Camp Staff.Medication must be in original container and ALL medication must be given to the staff to hold and dispense.

Things to Bring Daily:Campers must wear covered shoes to the site everyday. They should also pack daily snacks, sunblock, water bottle, towel, swimsuit, and extra clothes. See: Camp Gear List.

CONTACT INFORMATIONCamp Timberline Direct Phone: 808-672-5441 or toll-free at 877-672-4386Camp Timberline’s Fax: 808-672-6293Camp Timberline’s Email: info@kamaainareservations.com Camp Timberline’s Mailing Address: Camp Timberline c/o He‘eia State Park, 46-465 Kamehameha Hwy, Kaneohe, Hawaii 96744Camp Timberline’s Camp Director: 808-306-0870If you wish to send a letter or package to your child please send to:Camp TimberlinePO Box 700308Kapolei HI 96709-0308

Residential Camp Programs46-465 Kamehameha Hwy • Kaneohe, Hawaii 96744Phone: 808-235-6509 • Fax: 808-235-6519Email: info@kamaainareservations.comwww.kamaainakids.com

Rev.4/15/14

Check List:

___ Waiver ___ Form 14 6 months

Camp Gear ListLABEL ALL GEAR & CLOTHING ITEMS WITH YOUR NAME OR INITIALS!!!

____ Sleeping bag & pillow____ Change of clothes for each day____ Insect repellant lotion (no spray, remember dengue!)____ Sunblock SPF 30-50 (required for everyone, must be applied daily)____ Large flashlight____ Swim suit/rash guard____ Toiletries____ Covered shoes/reef walkers/slippers____ 1 long jeans____ Jacket/Sweatshirt____ Water bottle____ 3 old towels (1 for beach, 1 for shower, 1 extra)____ Quiet morning activity (book)____ Mess kit in mesh bag (plastic/metal bowl, plate, cup, fork & spoon)

Campers wash their dishes after every meal & hang it on clothesline, in mesh bag, to drip dry.____ Camera (disposable is best) & Snacks (must have Ziplocs to seal opened snacks)

____ Great Attitudes, Smiles, Good Weekend Rest!!!

THINGS NOT TO BRING TO CAMPRadios, watchman TV’s, jewelry, drinks, excessive amounts of money (more than $20), knives and weapons. These items can be confiscated from the camper and the parent may be called on a case-by-case basis. Any form of drugs, cigarettes or tobacco is illegal and if brought to camp, the camper will be sent home immediately, with no refund of tuition.

MP3/CD Players with earphones, electronic games and cell phones are permitted on overnight camping trips, but can only be used at designated times with permission from the Camp Counselors and are the exclusive responsibility of the camper. Camp Counselorsreserve the right to confiscate any music that is deemed inappropriate for young teens. These items are the exclusive responsibilityof the camper and Kama’aina Kids and Camp Timberline will not be held liable for them in all situations, whether it is lost, broken,misplaced or presumed stolen.

MONEY & VALUABLES RULECampers should not carry more than $20 or any valuables with them on any camp or excursion. Any extra money not needed at the time should be given to the camp office bank for proper storage and securing. All money and valuables are the exclusiveresponsibility of the camper and Kama’aina Kids or Camp Timberline will not be liable for it in all situations, whether it is lost, misplaced or presumed stolen.

Residential Camp Programs46-465 Kamehameha Hwy • Kaneohe, Hawaii 96744Phone: 808-235-6509 • Fax: 808-235-6519Email: info@kamaainareservations.comwww.kamaainakids.com

Rev.4/15/14

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