YMCA CAMP HIGH HARBOUR SERVICES PARENTS CHECKLIST This checklist is designed to help parents have everything in order before their camper arrives at camp on opening day. We suggest going over each item at least two weeks prior to the start of your camper’s session. If you have any questions, please call the camp office at (770) 532-2267. IMPORTANT DATES TO REMEMBER ____ All fees are due by April 15th. ____ Open House for new campers is held in April. Call office for more details. IMPORTANT FORMS FOR CAMP ____ 1 Health Form (four sides of paper) •must be signed by a physician •a new health form must be completed each year ____ Copies of insurance card and prescription card must be attached to health form ____ 1 Medication List •any medications must be checked in with nurse ____ Directions to Camp ARRIVAL AND DEPARTURE PROCEDURES ____ Arrival time for all campers is Sunday from 2:00 pm. - 4:00 p.m. ____ Departure time for all campers is Saturday from 10:00 a.m. – 11:00 a.m. ____ Boat departures must be cleared through the camp office by noon on Friday. ____Campstore balances must be paid on closing day. ____Any changes in arrival or departure of a camper must be cleared through the camp office. Please Note: Campers or parents are not allowed into cabins prior to the check-in time. Due to the ongoing preparation for camp and fairness to all, this time is strictly enforced. We also ask that you stay in your vehicles until checked-in by a staff member.

IMPORTANT INFORMATION IMPORTANT PHONE NUMBERS Gainesville Camp Services Office (770) 532-2267 - phone (770) 287-0852 - fax 1-800-954-5586 ESA - Fax on demand Lake Burton Office (706) 782-6311 Fax (706) 782-8407 Lake Allatoona Office (770) 966-9668 Fax (770) 966-9424 CAMPER MAIL All camper mail must have a cabin number and camper name (as in our system) to insure proper distribution and addressed as follows: (UPS and FedEx deliver to these addresses) We will not accept mail with postage due. Any mail coming after your camper leaves camp will be forwarded to your home address. Lake Burton campers: Camper Name Cabin # High Harbour at Lake Burton 685 Camp Harbour Lane Clayton, GA 30525 Lake Allatoona campers: Cabin # High Harbour at Lake Allatoona 40 Old Sandtown Rd Cartersville, GA 30121 PACKAGES Due to the extremely large number of packages we receive daily, we are asking that parents no longer send boxes of any size to camp. We have limited space to store things in the cabins. We have limited ability to dispose of boxes, filler and trash. We will gladly accept an envelope that is no larger than 12”x15”x3/4”, otherwise known as:

• A USPS Bubble Mailer • UPS Size 5 Envelope • A FedEx Large Pak

Any packages received outside of these guidelines listed above will have a camp handling fee of $1.99 per package charged to your camper’s store account.

YMCA CAMP HIGH HARBOUR THINGS TO PACK LIST Please TAPE ONE COPY TO THE LID of the suitcase or trunk and RETAIN ONE COPY AT HOME. We make every effort to return lost items by displaying all lost and found daily at lunch and dinner. PLEASE LABEL ALL ITEMS SENT TO CAMP with first and last names. CLOTHING LIST ____10 Shirts or T-Shirts* ____7 pairs of Shorts ____2 pairs of Long Pants ____10 pairs of Underclothes ____10 pairs of Socks ____2 pairs of Sneakers ____1 Light Jacket ____1 Sweater or Sweatshirt ____2 Swimsuits (One pieces/tankinis preferred) ____2 Bath Towels ____1 Poncho or Raincoat ____2 Pairs of Pajamas Dress Code: Halter tops, tube tops, “spaghetti” strap tops or bikinis are NOT appropriate attire for camp. One piece bathing suits or tankinis preferred for females. Campers wearing inappropriate bathing suits will be asked to put on t-shirts or shorts. All sleeveless shirts must have shoulder straps at least 1 inch in width. The camp staff reserve the right to ask a camper to change any clothing deemed inappropriate. BEDDING** ____1 Sleeping Bag (a must for older Pathfinders, Trailblazers, Watersports, ALCs and LITs for Lake Burton campers; ALL campers at Lake Allatoona need a sleeping bag.) ____2-3 Sheets (a must; twin size - fitted or flat) ____1 Blankets ____1 Pillow ____1 Pillow Case **Campers are expected to sleep on sheets and make bed while in camp** TRUNK SIZE recommendation: (Trunks are recommended but not required.) 15 inches or less in height. OTHER ITEMS ____Shower caddy or bucket for toiletries ____Soap and Soap Dish ____Shampoo ____Wash Cloth ____Toothbrush and Paste ____Comb/Brush ____Flashlight with Batteries ____Bible ____Writing Materials* and Stamps ____Laundry Bag

____Sunscreen (a must)* OPTIONAL EQUIPMENT ____Handkerchiefs ____Sun Glasses ____Compass ____Fishing Tackle ____Camera and Film ____Bug Repellent ____Hat* ____Canteen or Water Bottle ____Costumes for Skits and Theme Week SPECIAL THINGS TO BRING FOR TRAILBLAZER CAMPERS ____Hiking Boots or High Top Sneakers ____Sleeping Bag (a must for WS/TB/ALC/LIT at Lake Burton; a must for ALL Lake Allatoona campers.) All other necessary equipment is supplied for campers. ____Flashlight (highly recommended) IMPORTANT FORMS TO BRING TO CAMP ____ 1 Health form (four sides of paper) ____ 1 Medication List ____ Copy of Insurance/Prescription Cards *Can be purchased at the Camp Store DO NOT BRING TO CAMP •Food or cash (we do not have drink machines) •Spray Cans: roll-ons and liquids are preferred •Any device that can access the internet or social media: Cell phones, CD players, ipods, MP3, e-readers •Valuables - Jewelry, etc. •Knives, guns, fireworks etc. Bringing any of the items listed is STRICTLY against the policies of YMCA Camp High Harbour. Camp will not be held responsible for any of these items if brought to camp.

Name: _________________________________________________________________________ D.O.B.: ____________________

Allergy to: __________________________________________________________________________________________________

Weight: ________________ lbs. Asthma: [ ] Yes (higher risk for a severe reaction) [ ] No

PLACE PICTURE

HERE

1. Antihistamines may be given, if ordered by a

healthcare provider.

2. Stay with the person; alert emergency contacts.

3. Watch closely for changes. If symptoms worsen,

give epinephrine.

PARENT/GUARDIAN AUTHORIZATION SIGNATURE DATE PHYSICIAN/HCP AUTHORIZATION SIGNATURE DATE

FORM PROVIDED COURTESY OF FOOD ALLERGY RESEARCH & EDUCATION (FARE) (WWW.FOODALLERGY.ORG) 5/2014

1. INJECT EPINEPHRINE IMMEDIATELY.2. Call 911. Tell them the child is having anaphylaxis and may

need epinephrine when they arrive.

• Consider giving additional medications following epinephrine:

» Antihistamine

» Inhaler (bronchodilator) if wheezing

• Lay the person flat, raise legs and keep warm. If breathing is

difficult or they are vomiting, let them sit up or lie on their side.

• If symptoms do not improve, or symptoms return, more doses of

epinephrine can be given about 5 minutes or more after the last dose.

• Alert emergency contacts.

• Transport them to ER even if symptoms resolve. Person should

remain in ER for at least 4 hours because symptoms may return.

HEART Pale, blue,

faint, weak

pulse, dizzy

MOUTH Significant

swelling of the

tongue and/or lips

OR A

COMBINATION of symptoms from different body areas.

LUNG Short of breath,

wheezing,

repetitive cough

SKIN Many hives over

body, widespread

redness

GUT Repetitive

vomiting, severe

diarrhea

NOSE Itchy/runny

nose,

sneezing

MOUTH Itchy mouth

SKIN A few hives,

mild itch

GUT Mild nausea/

discomfortTHROAT

Tight, hoarse,

trouble

breathing/

swallowing

OTHER Feeling

something bad is

about to happen,

anxiety, confusion

Epinephrine Brand: __________________________________________

Epinephrine Dose: [ ] 0.15 mg IM [ ] 0.3 mg IM

Antihistamine Brand or Generic: _______________________________

Antihistamine Dose: __________________________________________

Other (e.g., inhaler-bronchodilator if wheezing): __________________

____________________________________________________________

MEDICATIONS/DOSES

SEVERE SYMPTOMSMILD SYMPTOMS

FOR MILD SYMPTOMS FROM MORE THAN ONE SYSTEM AREA, GIVE EPINEPHRINE.

FOR MILD SYMPTOMS FROM A SINGLE SYSTEM AREA, FOLLOW THE DIRECTIONS BELOW:

FOR ANY OF THE FOLLOWING:

NOTE: Do not depend on antihistamines or inhalers (bronchodilators) to treat a severe reaction. USE EPINEPHRINE.

Extremely reactive to the following foods: ____________________________________________________________

THEREFORE:[ ] If checked, give epinephrine immediately for ANY symptoms if the allergen was likely eaten.

[ ] If checked, give epinephrine immediately if the allergen was definitely eaten, even if no symptoms are noted.

EPIPEN® (EPINEPHRINE) AUTO-INJECTOR DIRECTIONS

1. Remove the EpiPen Auto-Injector from the plastic carrying case.

2. Pull off the blue safety release cap.

3. Swing and firmly push orange tip against mid-outer thigh.

4. Hold for approximately 10 seconds.

5. Remove and massage the area for 10 seconds.

AUVI-QTM (EPINEPHRINE INJECTION, USP) DIRECTIONS

1. Remove the outer case of Auvi-Q. This will automatically activate the voice instructions.

2. Pull off red safety guard.

3. Place black end against mid-outer thigh.

4. Press firmly and hold for 5 seconds.

5. Remove from thigh.

ADRENACLICK®/ADRENACLICK® GENERIC DIRECTIONS

1. Remove the outer case.

2. Remove grey caps labeled “1” and “2”.

3. Place red rounded tip against mid-outer thigh.

4. Press down hard until needle penetrates.

5. Hold for 10 seconds. Remove from thigh.

OTHER DIRECTIONS/INFORMATION (may self-carry epinephrine, may self-administer epinephrine, etc.):

2

2

2 3

3

4

1

2

PARENT/GUARDIAN AUTHORIZATION SIGNATURE DATE

FORM PROVIDED COURTESY OF FOOD ALLERGY RESEARCH & EDUCATION (FARE) (WWW.FOODALLERGY.ORG) 5/2014

EMERGENCY CONTACTS — CALL 911

RESCUE SQUAD: ______________________________________________________________________

DOCTOR: _________________________________________________ PHONE: ____________________

PARENT/GUARDIAN: ______________________________________ PHONE: ____________________

OTHER EMERGENCY CONTACTS

NAME/RELATIONSHIP: __________________________________________________________________

PHONE: ______________________________________________________________________________

NAME/RELATIONSHIP: __________________________________________________________________

PHONE: _______________________________________________________________________________

Treat the person before calling emergency contacts. The first signs of a reaction can be mild, but symptoms can get worse quickly.

ASTHMA ACTION CARD Camper Name: __________________________________Session:_______ Cabin:_______ Parent/Guardian Name: Ph: (h):_______________ Ph: (w): ____________________ Parent/Guardian Name: Ph: (h): _______________Ph: (w): ____________________ Emergency Phone Contact #1____________________________________________________________ Name Relationship Phone Emergency Phone Contact #2____________________________________________________________ Name Relationship Phone Physician Treating Camper for Asthma: _____________________________ Ph:____________________ Other Physician:________________________________________________ Ph:____________________

EMERGENCY PLAN

Emergency action is necessary when the student has symptoms such as, _________________ , ______________, _______________ , ______________or has a peak flow reading of ________________. Steps to take during an asthma episode: 1. Check peak flow. 2. Give medications as listed below. Student should respond to treatment in 15-20 minutes. 3. Contact parent/guardian if____________________________________________________________ 4. Re-check peak flow. 5. Seek emergency medical care if the student has any of the following: Coughs constantly No improvement 15-20 minutes after initial treatment with medication and a relative cannot be reached. Peak flow of ______________________ Hard time breathing with: . Chest and neck pulled in with breathing . Stooped body posture . Struggling or gasping Trouble walking or talking Stops playing and can.t start activity again Lips or fingernails are grey or blue . Emergency Asthma Medications Name Amount When to Use 1._______________________________________________________________________________________ 2._______________________________________________________________________________________ 3._______________________________________________________________________________________ 4._______________________________________________________________________________________

EMERGENCY PLAN

Asthma and Allergy Foundation of America

National Asthma Education and Prevention Program

DAILY ASTHMA MANAGEMENT PLAN . Identify the things which start an asthma episode (Check each that applies to the student.)

�

Exercise �� � ����� Strong odors or fumes � �� � Other _____________________ Respiratory infections � � � � Chalk dust / dust __________________________ Change in temperature � ������� Carpets in the room Animals � �� � ������� Pollens Food _______________________ � ��� Molds

Comments . Control of Environment (List any environmental control measures, pre-medications, and/or dietary restrictions that the student needs to prevent an asthmaepisode.) _________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ . Peak Flow Monitoring Personal Best Peak Flow number:___________________________________________________ Monitoring Times:_____________ _____________ _____________ _____________ . Daily Medication Plan Name Amount When to Use 1. ____________________________________________________________________________ 2. ____________________________________________________________________________ 3. _____________________________________________________________________________ 4. _____________________________________________________________________________ COMMENTS / SPECIAL INSTRUCTIONS _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ FOR INHALED MEDICATIONS � I have instructed _______________________________________ in the proper way to use his/her medications. It is my professional opinion that ________________________________ should be allowed to carry and use that medication by him/herself. � It is my professional opinion that _________________ should not carry his/her inhaled medication by him/herself. __________________________________________ _____________________ Physician Signature Date __________________________________________ _____________________ Parent/Guardian Signature Date AAFA . 1233 20th Street, N.W., Suite 402 , Washington, DC 20036 . www.aafa.org . 1-800-7-ASTHMA

Campers with Chronic Medical Issues YMCA Camp High Harbour has one or two medical staff on site at all times. Medical staff does not have specific training in “special needs.” Campers who require daily monitoring or have a chronic medical condition must provide a specific care plan from their specialist or primary care physician. This will be used by our medical staff to better serve your camper during his/her session(s) at camp. This includes but is not limited to:

• epilepsy • diabetes – a one-year baseline is required • cystic fibrosis • food allergies • asthma

Additional paperwork is required for these campers. If your camper requires constant one-on-one medical treatment, this remote camp setting may put your child at risk and you should look elsewhere for a specialized camp. We would be glad to recommend a camp for specific needs. YMCA Camp High Harbour does not knowingly purchase or serve peanut products. We order from a food service provider and cannot prevent cross contamination. We discourage and discard any peanut products we find brought in by campers. If you are worried about cross contamination, you have the option to pack your child’s meals for the week. If you are concerned, you may contact our food service director for the weekly menu. This must be done at least one month prior to your child attending. We work to the best of our ability to serve all campers. For the health and safety of your camper, other campers, staff, and medical staff, certain criteria and guidelines are in place for those with special medical needs. If your camper is unable to observe these guidelines and your child’s health or safety is at risk, you will be asked to pick him/her up.

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YMCA Camp High Harbour Frequently Asked Questions

Is YMCA Camp High Harbour an accredited camp?

Yes, we are fully accredited by the American Camping Association. Do you have daily devotions? Each evening, campers end the day with a devotional/discussion appropriate for their particular age group. All devotions are based on Christian values.

How are your staff trained and what is the camper-staff ratio?

Our staff complete a required staff training course each year before camp begins and must be certified in CPR, First Aid, AED and emergency water safety. All staff who work in or around water must be lifeguard certified. Our camper to staff ratio is 7:1. This number does not include our program directors and professional staff who live on-site. Do you have medical staff on-site?

Yes, each site has at least one medical personnel who lives on-site full time. We hire physicians, physician’s assistants and registered nurses to administer medications and first aid to your camper. Any prescription medications that need to be administered must be packed out by parents as noted in our parent information handbook. Our infirmary is fully stocked with all over-the-counter medications that campers might need. My child has special needs and/or requires a special diet. Can you accommodate this? Our goal is to offer a life changing camping experience to as many campers as possible; however, our camp

is not designed for a special needs camper. We can accommodate some special dietary needs, such as vegetarian; however, we cannot accommodate campers with life threatening food allergies that require special cooking processes. Also, due to the large number of campers who attend camp, we cannot accommodate campers who require one-on-one supervision. We do not knowingly serve peanut products at camp. However, we do purchase our food from large food vendors who mass produce food products in the same factories as peanuts. Also, we cannot monitor all food brought to camp by campers. If you need help finding a camp that can accommodate your camper’s needs, please call our office.

When are camp fees due and do I need to make monthly payments? All camp fees are due by April 15th, but a minimum monthly payment of $25 is required on all accounts. Do I need to have a new health form signed by a physician each year? Yes, all campers must have an updated health form that has been signed by a physician on file every year.

Your camper only needs a physical every 12 months, but the health form must be signed by your physician each year. Do I need to send my camper’s belongings in a trunk? If so, what size? Although most campers do use a trunk, it is not required. We ask that all trunks be no larger than 15 inches in height.

Do I need to send all the items listed on the “Things to Bring” list? Do I need to label my camper’s items? The list of clothing is a suggested list of items. We ask that you send old clothes and shoes to camp. All items that you send to camp should be labeled with your child’s first and last name, not just initials. Can I send a care package to my camper? Due to extremely large number of packages we receive daily we asking that parents no longer send boxes of

any size to camp. We have limited space to store things in the cabins. We have a limited ability to dispose of boxes and filler. We will gladly accept an envelope that is no larger than 12"x 15"x ¾", otherwise known as:

- A USPS Bubble Mailer - UPS Size 5 Envelope - A FedEx Large Pak

Can I send e-mails to my camper? Yes, a link to send camper e-mails will be listed during the summer on the home page of our website. All e-mails need to be sent before noon each day. Campers cannot respond to e-mails. When is arrival and departure from camp? Do you provide transportation? All arrival and departure times are detailed in our parent information handbook. Due to the very limited parking at our Lake Burton site, you will experience an extended wait time for those who choose to arrive

prior to 3 pm. Special circumstances for opening or closing day. Any special circumstances for opening day must be cleared through the camp office prior to camp. Any special circumstances for closing day must be cleared through the staff at the site your camper is attending.

Can my camper attend more than one session? Yes. Campers can attend multiple sessions at multiple sites. We offer special programs for carryover campers and we will also move your camper from one site to another if needed. Does my camper need to bring special clothes for the “theme of the week”? No. If campers have any costumes, decorations or accessories that are in line with the theme of the week, they can bring them. However, you do not need to purchase anything special for these themes.

Does camp have a dress code? Yes. The dress code is detailed in our parent information handbook. Can my camper bring a cell phone to camp? Can my camper make phone calls home? No. Cell phones are not allowed at camp. We ask that our parents please help us enforce this policy. If you are personally dropping your sons or daughters at camp, PLEASE take the cell phone(s) with you. A camper

caught possessing a cell phone has committed an honor code violation and will be ask to be picked up and removed from camp for the duration of their session. No refunds will be given to campers that are asked to leave for violating camp policies and procedures. Does my camper need money while at camp?

Your camper does not need any money at camp. For additional detailed information about camp, please see our Parent Information Handbook that is available online.