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YMCA CAMP ERDMAN YMCA of Honolulu Powered By Docstoc
69-385 Farrington Hwy., Waialua, HI 96791
P (808) 637-4615 F (808) 637-8874

Aloha Parents!
Thank you for registering your youth for summer camp at YMCA Camp Erdman. This summer will be a great
experience for them, they will try new activities, learn new skills and make new friends. For over 85 years
campers at YMCA Camp Erdman have walked through our gates, gazed out to the ocean, explored our mountains,
challenged themselves through exciting activities and experienced the support and friendship of caring staff
members and fellow campers. This is what has made Camp Erdman a memorable experience that kids come back
to year after year.

Giving your child the opportunity to attend YMCA Camp Erdman means that we will be partnering together to
provide them with the best camp experience possible so that they can develop meaningful relationships and create
lasting memories. This handbook is designed to help families prepare children for all that a summer at YMCA
Camp Erdman has to offer. If you have further questions after reviewing the handbook, please do not hesitate us.

Welcome to the YMCA Camp Erdman ohana. We look forward to seeing you this summer!

Edd Fishlock                                   Andrew VanDerWege
Resident Camp Director                         Senior Program Director

           OUR HISTORY                                 OUR VALUES                                      OUR STAFF
The 20 acres where Camp Erdman is         As a YMCA we focus on our 4 core               A great summer at camp begins with
now situated was once owned by one of     values of Caring, Honesty, Respect and         great staff members. We strive to offer
Hawaii’s most prominent families - The    Responsibility. We also embrace Hawaiian       a balance of creativity, sensitivity,
Dillinghams. In 1926, the family leased   culture and the values of:                     energy, enthusiasm, and experience at
the property to the YMCA. On August       •	 Malama – stewardship, sustainability,       camp. Our staff members are mature,
26th, 1931 Harold Randolf Erdman,            taking care of one another                  responsible, caring, and are committed
nephew of the Dillinghams, was injured    •	 Laulima – working together for a            to youth development. Counselors are
in a polo accident and passed away. To       common good                                 typically college students or graduates
honor his memory the Dillingham and       •	 Kuleana – the privilege of responsibility   who come to us with experience or
Erdman families bestowed the property     •	 ‘Imi ‘Ike – each person realizing their     training in outdoor recreation, leadership
to the YMCA of Honolulu and thus YMCA        human potential                             or education and have a diverse
Camp H.R. Erdman was founded.             •	 Aloha – loving & caring for each other      background of skills and talents.
                                          •	 Na’au Pono – doing the right thing
                                          •	 Olakino Maika’i – taking care of            All	staff	members	are	first	aid	and	
                                             yourself and celebrating your               CPR	certified	and	go	through	a	federal	
                                             achievements                                criminal background check. Staff
                                          •	 Loko Maika’i – sharing possessions and      also	have	training	and	certifications	
                                             knowledge                                   in	specific	program	areas.	All	water	
                                                                                         activities	are	supervised	by	certified	
                                          As a YMCA we are driven by our values          lifeguards. Staff training also covers
                                          and committed to being a positive              such topics as counseling skills,
                                          influence	in	the	lives	of	our	campers.         age appropriate programming, risk
                                                                                         management, homesickness, behavior
                                                                                         management and emergency procedures.
                                                                                         We maintain a 1 to 6 counselor to
                                                                                         camper ratio.
69-385 Farrington Hwy., Waialua, HI 96791
P (808) 637-4615 F (808) 637-8874
                                   OUR LOCATION                                                          GETTING TO CAMP
  CAMP N                                                                                        69 - 385 Farrington Hwy
 ERDMA                                                                                          Waialua, HI 96791
                                                                                                We operate a bus pick-up from 1:00pm -
                                                                                                1:30pm on Sundays and drop off at 5:30
                                                                                                pm - 6:00pm on Fridays at the Nuuanu Y.
                                                                                                If	your	camper	is	flying	in	to	Oahu	you	
                                                                                                must	fill	in	the	flight	information	form	so	
                                                                                                we can pick them up from the airport.

                                                                                                     A TYPICAL DAY AT CAMP
                                                                                                Each day at camp is different at camp
                                                                                                but here is a general daily schedule
                                                                                                •	 7:00 Rise & Shine
                                                                                                •	 7:45 Morning Oli (chants)
                                                                                                •	 7:45 Thought For The Day
We are located at 69-385 Farrington Hwy, just west of Waialua.                                  •	 8:00 Breakfast
                                                                                                •	 8:45 Details
        SUNDAY CHECK-IN                               FIRST TIME CAMPERS                        •	 9:00 Specialty Areas
PARENT DROP-OFF 1:30PM-2:30PM                 Sometimes	the	most	difficult	decision	about	      •	 12:00 Lunch
BUS PICK-UP 1:00PM-1:30PM                     a youth attending camp is not whether the         •	 12:30 Rest Time
•	 Welcome	and	sign-in                        youth wants to go, but whether mom and            •	 1:30 Store Time
•	 Deposit	 medications	 with	 our	 health	   dad can be away from the youth for a whole        •	 2:00 Ohana Time
   care manager                               week! Here are a few suggestions from
•	 Meet	counselor	and	cabin	mates
                                                                                                •	 3:45 Choice Time
                                              previous	first	year	parents:                      •	 5:30 Dinner
•	 Move	into	cabins                           1. Visit camp before your youth’s session.
                                                                                                •	 6:30 Evening Programs
                                              2. Contact	 the	 Camp	 Erdman	 office	 with	
                                                 any questions, and talk with other camp        •	 8:00		 Campfire
        FRIDAY CHECK-OUT                         parents in your area.                          •	 9:30 Lights Out (Age Dependant)
                                              3. Send your camper a letter or package.          SPECIALTY AREAS
PARENT PICK-UP 5:15PM-6:30PM                     Some parents send a letter before their
BUS PICK-UP 5:30PM-6:00PM                                                                       Campers gather in their specialty areas
                                                 youth leaves home so that it’s waiting at      of Traditional, Surf, Climbing, Riding
Join us at camp for our closing ceremony.        camp when they arrive.
We will be serving a dinner to campers                                                          or English As A Second Language. Our
                                              4. Parents miss their youth too, but try not      older traditional campers get to focus on
and parents at 5:30, followed by a short         to make this the emphasis of your letters
closing ceremony to conclude your child’s                                                       land based, aquatics based or arts and
                                                 to your camper. They will be happy to          crafts programs. Our youngest traditional
week at camp.                                    know how proud you are of them as they         campers are in our keiki kula - where
                                                 set off on this new adventure, but it will     they experience all aspects of camp.
Before you leave make sure you:                  sadden them to know how much the dog
•	 Sign-Out in Assembly Hall (Photo ID           misses them!                                   OHANA TIME
   Required)                                  5. Welcome your camper’s new friends              These times are spent in their Ohana age
•	 Pick up medication from our health care       and	have	confidence	in	their	judgement.	   	   groups (age 6 to 8, 9 to 11 and 12+)
   manager                                       Encourage your camper to pursue                doing activities such as Ropes Course,
•	 Check Lost & Found                            interests and skills they have picked up       Swimming, Hiking, etc.
                                                 at camp.
                                                                                                CHOICE TIME
                                                                                                This is a chance for campers to try new
                                                                                                and exciting activities including archery,
                                                                                                sports, group games, craft projects and
                                                                                                extra swimming time.
69-385 Farrington Hwy., Waialua, HI 96791
P (808) 637-4615 F (808) 637-8874
       HEALTH & WELLNESS                                     CAMP FOOD                           ITEMS TO LEAVE AT HOME
•	 Medication must be in its’ original         Camp is a place for kids, it’s also a place   Items that are found in camper’s
   container and will be dispensed as          to live a healthy lifestyle. With this in     possession	will	be	confiscated	and	held	
   instructed on the original container. Do    mind we serve 3 high quality meals a day,     by the Camp Director until the end of the
   not break from prescriptions without a      balancing the need to serve kid friendly      session. Parent must be present in order
   doctor’s authorization.                     food with the need to produce a healthy       to collect item.
•	 Be sure to include enough medication        menu. We think your child will be very        •	 Cell	Phones*				•	Laptops/iPads	
   for your child’s entire stay.               happy with our camp menu. We do serve         •	 Radios									 •	Jewelry
•	 All medications must be deposited           a vegetarian option at every meal. If your    •	 Cash	 	         •	Pets
   with the Camp Health Care Manager on        child	has	specific	dietary	needs	please	      •	 iPods/MP3	Players	
   check-in day.                               make sure you note this on their health       •	 Hair	Dryers/Curlers/Flat	Irons	
•	 Parent/Guardian	signature	is	required	      form.                                         •	 Portable	Games/DS/PSP
   to allow our Health Care Provider to                                                      •	 Non-prescription Drugs
   administer medication.
                                                                                             CELL PHONES
•	 If bed-wetting is a condition, contact                 WHAT TO BRING                      We feel that camp is a time to unplug
   the Camp Director.                          Camp is a fun and exciting place where        from technology and connect with
•	 We encourage parents to conduct a           kids get dirty and place a lot of wear        new friends. Cell phones are a big
   routine health screen on their child one    and tear on their clothing. We suggest        distraction from building our community.
   week before, and the day before arrival     packing clothes that are not brand new        Additionally, cell phones are easily lost or
   at camp. We are especially concerned        or too expensive. Remember to mark ALL        damaged at camp. Please support us by
   about contagious conditions including       personal items. Note that camp is NOT         having your child not bring a cell phone.
   flu,	fever,	conjunctivitis	(pink	eye),	     responsible for lost or stolen items.
   chicken pox or head lice. If any camper                                                   SNACKS
   exhibits symptoms of any contagious         •	 6	T-shirts	    •		6	Shorts/Pants	          Food in the cabins attracts animals and
   illness parents will be responsible for     •	 6	Underwear	 •		6	Socks	                   bugs. We will provide plenty of food, so
   taking the child to the doctor.             •	 2	Towels	      •		Hat/Visor	               please leave snacks at home.
•	 If your child becomes sick while at         •	 Light	Jacket	 •		Swimwear	
   camp,	parent	will	be	notified.              •	 Sleepwear		 •		Slippers	                            PROHIBITED ITEMS
•	 For sickness or injuries, parents will be   •	 Shower	Shoes	 •		Closed	Toed	Shoes	        Campers found using items to harm
   consulted to determine the course of        •	 Laundry	Bag		 •		Pillow	(travel	size)	     others or themselves or being under
   action. If immediate medical attention      •	 Water	Bottle		 •		Sunglasses               the	influence	of	or	in	possession	of	
   is required, the appropriate emergency      •	 Camera	        •		Flashlight               these items will not be tolerated and the
   authorities will be contacted and           •	 Sunscreen	     •		Chap	Stick               camper will be sent home. YMCA Camp
   the child will be transported to the        •	 Sleeping Bag (for packout)                 Erdman	may	also	file	a	report	with	the	
   hospital. All attempts will be made to      •	 Sheets (for cabin bunk)                    appropriate authorities in these cases
   notify parent.                              •	 Toiletries (shampoo, soap, etc.)           and refunds will not be given.
•	 Parents are responsible for all fees        •	 Insect Repellent                           •	 WEAPONS		 •		ALCOHOL	
   charged by attending physicians,            •	 Stationary (with self-stamped &            •	 TOBACCO		      •		DRUGS	
   ER,	EMS	and/or	pharmacy	for	any	               addressed envelopes)
   medications or services prescribed that
                                               Campers that are enrolled in                             LOST & FOUND
   are not immediately covered by your
                                               Horsemanship Camp or Rock Climbing            On closing days there will be an area
   existing insurance.                                                                       to claim all Lost & Found items and we
                                               Camp must bring the following items in
                                               order to participate in the program.          suggest that all families look through
           HOMESICKNESS                                                                      it before departing camp. Due to the
Our health supervisor and counseling staff     HORSEMANSHIP CAMP                             number of requests, we cannot mail
are trained in helping campers overcome        •	 Closed Toed Shoes (heeled boots*)          items. All remaining items are donated to
homesickness. Although uncommon,               •	 Long Pants (denim jeans*)                  a local charity at the end of the season.
homesickness can affect a campers              *preferred items
experience at camp if not handled with care
                                               ROCK CLIMBING CAMP                              CANCELLATIONS & CHANGES
and urgency. Parents will be contacted if
                                               •	 Reusable Water Bottle                      Cancellations and changes must be made
the homesickness continues for more than
                                               •	 Closed Toed Shoes (hiking boots*)          a month before the camp session. The
24 hours. Parents supporting the campers
                                               •	 Long Pants (denim jeans*)                  $150 deposit is non-refundable but the
decision to go to camp and meet their goals
                                               *preferred items                              rest of the program fee will be refunded.
greatly effects the outcome of the campers
                                                                                             There are no refunds if less than a
staying for the remainder of the week.
                                                                                             months notice is given.
69-385 Farrington Hwy., Waialua, HI 96791
P (808) 637-4615 F (808) 637-8874
           SPECIAL NEEDS                                 STAY IN TOUCH                           ACA ACCREDITATION
In accordance with the Americans with         MAIL                                        Camp Erdman is accredited by the
Disabilities Act (ADA), Camp Erdman           69 - 385 Farrington Hwy                     American Camp Association (ACA), the
makes reasonable accommodation for            Waialua, HI 96791                           nationally recognized accrediting body
individuals with special needs to enjoy                                                   for the camp industry. ACA accreditation
the	benefits	of	a	YMCA	program	                                                           means that Camp Erdman has undergone
                                              Phoning your camper is discouraged as it
experience. The Camp Director would                                                       a thorough (up to 300 standards)
                                              can cause homesickness or distract them
be happy to discuss special needs with                                                    review of its operation, from staff
                                              from making new friends. But feel free to
you personally; please call to set up an                                                  qualifications	and	training	to	emergency	
                                              call us to check in. (808) 637-8874
appointment. If your camper requires                                                      management. ACA collaborates with
an aid at school please call to set up an     FACEBOOK                                    experts from the American Academy of
appointment with our Camp Director. We        YMCA Camp Erdman                            Pediatrics, the American Red Cross, and
do ask that all campers be capable of                                                     other youth serving agencies to ensure
functioning in a 1:6 staff to camper ratio.   Campers love to get mail from home, so      that	current	practices	at	the	camp	reflect	
                                              please go ahead and write them a letter     the most up to date, research based
        BIRTHDAYS AT CAMP                     or send them a care package!                standards in camp operation.
Camp is a magical place to celebrate your
birthday, surrounded by new friends.                                                      For more information about the American
Make sure to let us know if it’s going to                                                 Camp Association, visit www.acacamps.
be your child’s birthday while they are                                                   org.
at camp - this way we can make sure
we include them in our camp birthday
69-385 Farrington Hwy., Waialua, HI 96791
P (808) 637-4615 F (808) 637-8874
           CAMP POLICIES                               EMERGENCY PLANS                                 OUTSIDE CONTACT
Our overall goal is to provide a safe and     TSUNAMI                                         At Camp Erdman, our pledge is to put
happy environment for each participant.       If	sufficient	advance	notice	is	received	all	   your children in the company of the
In order to provide the best possible         campers will be evacuated to a different        most trustworthy and appropriate young
experience for everyone, there are            YMCA branch. In the result of short             adults we can hire; counselors who are
certain policies and rules that you and       notice campers will evacuate to the camp        well suited to the task of caring for
your child need to know. . Please read        tsunami safe zone.                              campers.
over the following policies and share
them with your child.                         EXCESSIVE HOT WEATHER                           Camp is a well supervised place, however
                                              Activities will be provided indoors or in       once the season is over we can no longer
BEHAVIOR POLICIES                             shaded areas outdoors as appropriate.           supervise our seasonal staff. Therefore
When problems with behavior arise that        Water is accessible to children at all          it is a YMCA policy that we ask our staff
are beyond the normal range of issues         times and they are encouraged to drink          not to continue their friendship with
with children, staff will communicate         fluids	throughout	the	day.	                     your child outside of camp. This includes
those concerns to parents. Our goal is                                                        baby-sitting, being friends on facebook
then to create a plan with parents and        MEDICAL EMERGENCY                               or meeting campers outside of camp.
child to ensure that the child acts and       If a medical emergency arises, we will
behaves more positively with staff and        administer	first	aid	and	make	every	            Our recommendations is for you to be
peers. If behavior problems continue,         effort	to	contact	the	parent/guardian.		If	     aware of your child’s activities and online
permanent dis-enrollment may result.          emergency medical treatment is required,        friendships, and supervise them.
Please talk with the Camp Directors           we will contact a doctor, hospital, or call
                                              an ambulance depending on the severity
about any questions or concerns
                                              of the injury or illness.
                                                                                                       REQUIRED FORMS
regarding	the	behavior	and	specific	                                                          To complete your registration process
discipline policies concerning your child.    VEHICLE FAILURE OR ACCIDENT                     the following forms must be completed
The following are grounds for immediate       In case of a vehicle mechanical failure         and	in	our	office	by	June	1st.	If	you	have	
termination from YMCA programs                or	accident,	we	will	administer	first	aid	      already started the process or have sent
without a refund or credit:                   treatment as necessary. The vehicles            in your completed documents we ask that
                                              used by the YMCA are all supplied               you double check the list below.
•	 Anything that endangers the health         with	first	aid	materials.		Emergency	            HEALTH HISTORY/HEALTH EXAM
   and	safety	of	campers	and/or	staff         information on each child is taken along        The Health History (side 1) is mandatory
•	 Destruction of property                    on any outing away from the camp                for attendance at camp. The Health Exam
•	 Leaving camp boundaries or property        facility.		Parents	will	then	be	notified	as	    (side 2) is required ONLY IF camper has a
   without permission                         appropriate.                                    history	of	Asthma,	Heart	Defect/Disease,	
•	 Continued inappropriate behavior, i.e.                                                     Seizures, Diabetes, has been recently
   threatening, profane language, not         EMERGENCY COMMUNICATION                         hospitalized, or is currently under
   following directions, teasing, improper    In the event of an emergency situation,         Doctor’s care.
   behavior in a transportation vehicle       parents will be contacted by phone.              LETTER TO MY COUNSELOR
   and inappropriate sexual behavior.         Updates will also be posted to our              This form gives your child’s counselor
                                              website -                    more information and helps them get to
BEHAVIOR EXPECTATIONS                                                                         know your child.
•	 Act safely, do not take any unneeded       If a parent has an emergency and needs           STORE ACCOUNT
   risks.                                     to	locate	his/her	child,	or	is	concerned	       Our camp store sells t-shirts, souvenirs,
•	 Follow the rules of the camp and the       about a schedule change they should             snacks, drinks, etc. Campers are not
   staff.                                     call the camp.                                  permitted to use cash at the store.
•	 Speak for yourself, not for anyone else.                                                   Instead, parents will create a store
•	 Listen to others, then they’ll listen to                                                   account for their camper by completing
   you.                                                                                       the “Store Account Form”.
•	 Avoid put-downs…who needs them?                                                             SPECIALTY WAIVER FORMS
•	 Stay with your group at all times.                                                         Parents who have campers enrolled in a
•	 Show respect to yourself, others and                                                       Specialty Camp (Horsemanship or Surf)
   the environment.                                                                           must	complete	a	specific	waiver	in	order	
•	 Take charge of yourself, you are                                                           to participate in those programs.
   responsible for you!                                                                        FLIGHT INFORMATION
•	 Be the best you can be… it makes a                                                         To ensure proper transportation
   real difference!                                                                           arrangements are made, it is important
•	 Have Fun !                                                                                 that this form is completed.
69-385 Farrington Hwy., Waialua, HI 96791
P (808) 637-4615 F (808) 637-8874

                                   LETTER TO MY COUNSELOR
Thank you so much for joining us at YMCA Camp Erdman. Please help us learn a little bit about you by sharing about yourself. This
form will be shared with your child’s counselor so they can be prepared to meet your and your child’s expectations. We look forward
to seeing you at camp this summer!
                                                               FOR PARENTS
Child’s name:

Has your child been away from home or at an overnight camp before?
If yes, please explain:

What would you like your child to gain from their camp experience this summer?

Please describe any special behaviors or circumstances that the staff at Camp Erdman should be aware of:

Please list the people living in the home and their relationship to the camper:

Anything else you would like to share with us:

                                                                FOR CAMPER

Nickname or Name you go by:                                                                   Please attach a photo of yourself:

If you have been to camp before, what did you like about it?

What are you looking forward to at camp this summer?

What activities are you interested in doing at camp?

Is there anything that you are nervous about at camp?

Cabinmate Request:

*cannot	be	guaranteed,	age	must	be	within	1	year	of	you,	please	include	first	and	last	name   (Silly photos are strongly recommended)
69-385 Farrington Hwy., Waialua, HI 96791
P (808) 637-4615 F (808) 637-8874

                                         HEALTH HISTORY FORM 2012
CAMPER INFORMATION                                             PLEASE PRINT CLEARLY - This is camp’s permanent record.
Last                                                           First                                                                   Male
Name:                                                          Name:                                                                   Female         DOB:						/							/       Age:
FAMILY INFORMATION:                  Applies to those with whom the camper legally resides. Non-custodial parent information is on registration form
Address:                                                       Parent/Guardian	1                                                   Parent/Guardian	2
                                                               Last Name:                                                          Last Name
City:                                                          First                                                               First
                                                               Name:                                                               Name:
State                                                          Work                                                                Work
Province:                     Zip:                             Phone:                                                              Phone:
Home                                                           Cell                                                                Cell
Phone:                                                         Phone:                                                              Phone:
Family                                                         Emergency Contact #1                                                Emergency Contact #2
Physician:                                                     (Not	Parent/Guardian):	                                             (Not	Parent/Guardian):	

Insurance Carrier &                                            Home                                                                Home
Policy #:                                                      Phone:                                                              Phone:
                                                               Cell                                                                Cell
Phone:                                                         Phone:                                                              Phone:
Are all immunizations up to date?                 Yes         No     Date of last tetanus shot:                                  Date of last physical:

Describe	any	camp	activities	from	which	the	camper/staff	should	be	exempted	for	health	reasons.

Describe past medical treatment including dates, if any.

Describe any allergies or dietary restrictions.

What	current	medications,	prescribed	and	over-the-counter,	are	to	be	continued	at	camp?	(dosage/frequency)

Describe any current physical, mental, or psychological conditions requiring medication, treatment, or special restrictions or considerations while at camp?

(Girls) Has this camper Menstruated?                                   If no, has she been told about it?                            If yes, is menstrual history normal?
                                                         Medical Information past or present (please check).
                         If any of the items below apply to your child, you must have a Doctor’s Authorization completed (see reverse side).
    Currently under Dr. Care                 	Heart	defect/disease								 Recent hospitalization                           Asthma               Seizures                Diabetes
                                                          Important - The section below must be complete for attendance
This health history is correct and complete as far as I know. The person herein named has permission to engage in all camp activities except as noted. I hereby give permission to the
camp	to	provide,	seek,	and	consent	to	routine	health	care,	administration	of	prescribed	medications,	and	emergency	treatment	for	me/my	child,	as	may	be	necessary,	including,	but	not	
limited	to	x-rays,	routine	tests	and	treatment,	and/or	hospitalization.	I	also	give	permission	for	the	camp	to	arrange	related	transportation.	I	agree	to	the	release	of	any	records	neces-
sary for treatment, referral, billing, or insurance purposes. It is my intention that the camp be treated as acting in loco parentis if the person herein named is a minor. Further, it is my
intention that the appropriate representatives of the camp be treated as “personal representatives” for the purposes of disclosing protected health information pursuant to the privacy
regulations promulgated pursuant to the Health Insurance Portability and Accountability Act of 1996. I hereby agree (pursuant to 45 CFR § 164.510(b)) to the disclosure to camp repre-
sentatives of the protected health information of the person herein described, as necessary: (i) to provide relevant information to the camp representatives related to the person’s ability
to participate in camp activities; and (ii) in the case of minors, to provide relevant information to the camp representatives to keep me informed of my child’s health status. In the event
I cannot be reached in an emergency, I hereby give permission to the physician selected by the camp to secure and administer treatment, including hospitalization, for the person named
above. This completed form may be photocopied for trips out of camp.

Signature	of	parent	or	guardian	or	adult	camper/staffer:	________________________________________	Date:_____________________________

                                                                                                                                                                 This form continued on back.
69-385 Farrington Hwy., Waialua, HI 96791
P (808) 637-4615 F (808) 637-8874

  Note: A Doctor’s written authorization is only required if the camper has a history of Asthma, Heart Defect/Disease, Seizures, Diabetes, has been
                              recently hospitalized, or is currently under a Doctor’s care. If so, complete this section.

                                                  Health Examination by Licensed Physician

Child’s name:                                                                            Birth date:                           Sex:

Parent’s name:
Because of this camper’s medical history, we have asked that your written authorization be provided prior to their attendance at YMCA Camp
Erdman. Please realize that camp is held in an outdoor setting. The programs are very active with strenuous hiking, games, swimming, and camp
activities.	Horseback	riding,	rock	climbing,	and	surfing	are	optional	activities.	Your	careful	consideration	is	appreciated.

I have examined the child named on this form within the past two years.       Yes  No                Date examined:

Height:                                               Weight:                                          Blood pressure:
After	examination	and	my	review	of	his/her	health	history,	it	is	my	opinion	that	this	person	is	physically	able	to	engage	in	camp	
activities, except as noted below.
Is the applicant under the care of a physician for any conditions?                  Yes      No                 Please explain below:

Any	specific	activities	to	be	encouraged	or	limited	by	physician’s	advice?

Any medically prescribed meal plan or dietary restrictions?

Any treatment or medications to be continued at camp (please give time, method and quantity of doses):

Any allergies? (Food, drugs, plants, insects, etc):

Additional health information:

Licensed physician signature:                                                                          Date:

Address:                                                                                               Phone:

Date of form completion:                                                                               By:
69-385 Farrington Hwy., Waialua, HI 96791
P (808) 637-4615 F (808) 637-8874

                                       STORE ACCOUNT FORM
A	credit	card	is	needed	on	file	for	camper	purchases	from	our	camp	store.	This	Camp	Store	Form	must	be	completed	with	the	spend-
ing limit and Credit Card information. Setting the spending limit for your camper will eliminate the chances of overcharging your
account. If a limit is not indicated on the form, we will then assume that the limit is zero. If the Credit Card information is not listed
then the form is incomplete and we will then assume that your child will not be able to purchase items from the Camp Store.

Camper                                                       Camper
Last Name:                                                   First Name:

 YES, my camper is able to purchase items from the Camp Store.                         Limit
 NO, my camper is NOT able to purchase items from the Camp Store.                      up to $

All credit cards are processed at the end of each week. Upon check-out you will receive a list showing the items that your camper
has purchased.

 VISA        Master Card       American Express         Discover
Card                                                                                              Expiration
Number:                                                                                           Date:
Address:                                                     City:                                State:          Zip:
Name on                                                                                           Phone
Card:                                                                                             Number:

Signature:                                                                                        Date:

 CAMP STORE ITEMS Items and prices may change without notice

           Drinks              $1.00 - $1.50                Juice	/	Soda	/	Water
           Sweets              $.25 - $1.50                 Candy	/	Cookies	/	Chips
           Snacks              $.50 - $2.00                 Nuts	/	100	Calorie	Snacks	/	Assorted	Granola	Bars
           Ice Cream           $1.00 - $3.50                Push-up	/	Dibs	/	...and	More!
           Clothing            $15.00 - $30.00              T-Shirts	/	Tank	Tops	/	Hoodies
           Camp Souvenirs      Frisbee - $3.00              Dog Tag - $5.00                   Bumper Stickers - $2.00
                               Pencils - $.50               Hat - $10.00                      Water Bottles - $10.00
                               Flashlight - $7.00           Pens - $2.00                      Carabiner - $3.50
                               Bandana - $5.50

 RESTRICTIONS Please list any restrictions (no soda, no candy, no souvenirs etc.)
69-385 Farrington Hwy., Waialua, HI 96791
P (808) 637-4615 F (808) 637-8874

                                FLIGHT INFORMATION SHEET
Camper                                                        Camper
Last Name:                                                    First Name:
Child’s Description (Please include a current photo):

Parent	/	Guardian	        	        	        	        	        	        	          Parent	/	Guardian
Last Name:                                                                        First Name:
Home                                            Work                                              Cell
Phone:                                          Phone:                                            Phone:


 FLIGHT PARAMETERS 		If	you	have	trouble	booking	flights	within	our	parameters,	please	contact	us.
Please	arrange	flights	into	and	out	of	Honolulu	International	Airport	at	the	allotted	times	(Hawaiian	Standard	Time)	listed	below.	
Upon arrival Camp Staff will be in the “Baggage Claim Area”, wearing BLUE shirts & holding a noticeable sign.
                             ARRIVAL                                                            DEPARTURE
                    Schedule time before 2pm,                                           Schedule time after 8:00pm,
              on	the	first	day	of	program	enrolled	in.                             on the last day of program enrolled in.

 Date:                                                                 Date:
 Airline:                                                              Airline:
 Flight #:                                                             Flight #:

 Time:                                                                 Time:

Please provide the information below to avoid any delays or confusion that may occur upon checking into the airport. If your child is a minor
you should check with the carrier on their procedures for the release of your child. (If different from above)
Name	of	Parent	/	Guardian	         	        	        	        	        	           	
receiving child:
Home                                             Work                                            Cell
Phone:                                           Phone:                                          Phone:

In the unlikely event that our Camp Staff is not in the “Baggage Claim Area” when your child arrives, we would like for your child to
hand an airline representative our information and to ask them to contact us, so that we are able to arrange a safe place for your
child until our Camp Staff arrive. Please make sure your child has Camp’s information handy.
                                     Address: 69-385 Farrington Hwy., Waialua, HI 96791
                              Main Phone: (808) 637-4615     Emergency Phone: (808) 225-6662
69-385 Farrington Hwy., Waialua, HI 96791
P (808) 637-4615 F (808) 637-8874

                    SURF SPECIALTY CAMP WAIVER
69-385 Farrington Hwy., Waialua, HI 96791
P (808) 637-4615 F (808) 637-8874


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