Camp CHAT Application 2011 by pengxuebo


									                             CAMP CHAT
                               Because      Children Have
                                        Arthritis Too!!

           Camp Application
Sunday, July 24th—Friday, July 29th, 2011

        Part 1 Due May 15th, 2011

    The Arthritis Foundation, New Jersey Chapter
           555 Route 1 South, Suite 320
                  Iselin, NJ 08830
         732-718-0623 ~ 732-283-4300
                            Camp CHAT 2011
                             July 24th - July 29th, 2011
                                   Camp Merry Heart
                                      21 O’Brien Road
                            Hackettstown, NJ 07840-9802

Dear Parents/Guardians,

Welcome to the 2011 Camp CHAT application process! Come join us for our 9th
exciting year of Camp CHAT! We have a two-step application procedure . This booklet
serves as the first step.

Enclosed, you will find all the information you need to know about Camp CHAT. This
booklet can be used as a guide to help you through the application process. The last
page is the actual application form which you must fill out and return to have your
child considered for camp. If your child meets all of the eligibility requirements, you
will be notified by June 1st, 2011.

After your child has been accepted to camp, you will receive another packet. This
packet will include all the forms that need to be completed for your child to attend
Camp CHAT.

Please do not hesitate to call Gloria Hennessey or Christine Citera with any questions
or concerns you may have. Gloria can be reached at 732-283-4300, ext. 321 or Christine can be reached at 732-718-0623 or

Best regards,

Peggy Lotkowictz                                        Christine Citera
Vice President, Mission Delivery                        Camp Coordinator
                       Frequently Asked Questions

What is Camp CHAT?
Camp CHAT (Children Have Arthritis Too) is a six-day sleep-away camp for children
ages 8-16 with juvenile arthritis and other rheumatic diseases. It gives the children
and teenagers an opportunity to become friends with others who face similar
challenges as they do. Through activities in which everyone succeeds, and educational
sessions, the campers learn how to manage and cope with their disease, while having

What activities does Camp CHAT provide?
        • Swimming                              • Challenge Course & Zip Line
        • Paint Ball                            • Rock Band & Karaoke
        • Rock Climbing                         • Option to camp out for a night
        • Arts & Crafts                         • Special night events such as
        • Boating & Fishing                      campfire & a themed dance
        • Yoga                                  • Field Trips for Teens
        • Sports & Recreation                   • Nature Activities

Where is Camp CHAT located?
Camp CHAT is located at Camp Merry Heart, an Easter Seals camp, in
Hackettstown, NJ. It is completely wheelchair accessible and designed for
children who have chronic diseases and physical disabilities. Campers sleep in cabins.
The campsite includes an arts and crafts building, in-ground pool with a solar cover,
playground, basketball court, sports fields, lake for boating and fishing, rock climbing
wall, haunted “shack”, outdoor pavilion, dining hall, shower house, and a medical
Who is eligible for Camp CHAT?
Children between the ages of 8 and 16 who have juvenile arthritis or another
rheumatic disease are welcome to apply for camp if they meet our eligibility
requirements. New campers who are 16 years of age must obtain a recommendation
from their pediatric rheumatologist. A recommendation is NOT required for campers
who are now 16 years of age and have attended Camp CHAT before. Any 16 or 17
year old may apply to be either a camper or a Peer-Group-Leader-In-Training (PGLIT).

All applicants must have been seen by a rheumatologist regarding their rheumatic
disease within the past 12 months.

What is the cost of Camp CHAT?
Camp CHAT is a costly venture but with the help of our donors, no camper will be
turned away because of financial circumstances. When you call for more information,
just request an easy-to-complete scholarship application. Thanks to our generous
funders, the Independent Order of Odd Fellows, AMGEN, Hummingbird
Foundation and Church & Dwight, the cost to send a child to Camp CHAT is $350
which is only a third of the actual cost per camper. A $50, non-refundable registra-
tion fee is due when you send in your camp application. However, if you meet schol-
arship criteria, additional tuition will be waived.

What staff are at Camp CHAT?
Camp CHAT is staffed by trained counselors, activity specialists, and a full-time camp
director. Additionally, a pediatric rheumatologist will be present at camp during the
day. A minimum of two nurses will be on site around the clock to dispense medication
and take care of medical emergencies. Peer Group Leaders (PGL’s), who are young
adults with arthritis, will be at camp during the week to serve as role models and lead
the educational activities. All staff and volunteers working with the children have been
screened in accordance with New Jersey State Law.
What is a Peer-Group-Leader-In-Training (PGLIT)?
A PGLIT is a 16 or 17 year old with juvenile arthritis or another rheumatic
disease who wants to be a role model for the other campers with the prospect of
becoming a Peer Group Leader when they turn 18 years of age. PGLIT’s will help out
with educational activities, yoga and exercise, and the special night activities. It is
extremely important for PGLIT’s to obey camp rules and guidelines so that they set a
good example for the younger campers. If you would like to apply as a PGLIT, please
check the box on the application form and more information will be sent to you.

What is a Peer Group Leader?
A Peer Group Leader is any person ages 18 and up who has been diagnosed with
juvenile arthritis or another rheumatic disease. PGL’s may spend 2-6 days at camp
and serve as role models and mentors to the campers. If you would like more infor-
mation on how to apply, please contact Christine Citera at 732-718-0623 or

Are parents allowed to visit?
Parents are more than welcome to visit on opening and closing days when they drop
off or pick up their child. However, visitors are prohibited at other times since it will
disrupt the camp schedule and hinder participation in camp activities. If you are
unsure that your child is ready for camp, you and your child may visit the campsite on
Wednesday, July 27th, 2011 to observe the fun activities we offer! This will prepare
your child for the 2012 camp season. Please contact Gloria Hennessey at if you plan to visit.

How do the campers get to and from camp?
In most cases, campers’ families are responsible for providing their own
transportation to and from Camp CHAT. However, the Arthritis Foundation will
provide bus transportation to and from the office in Iselin, NJ and from Hackensack
University Hospital, Hackensack, NJ if, and only if, it is impossible for you to make
other transportation arrangements.
How do I apply my child for Camp CHAT?
Fill out the attached application form and return it to:

Arthritis Foundation, NJ Chapter
555 Route 1 South, Suite 320
Iselin, NJ 08830

Please include the $50 registration fee! We reserve the right to return any
incomplete applications and reject any applicant who does not meet our
eligibility requirements. After your child has been accepted to camp, the
medical forms packet will be mailed to you which must be returned to reserve their
camp spot. If declined, the $50 fee will be returned. If accepted, the $50 fee is non-
         Criteria for Admission to Camp CHAT

1. Applicants must be between the ages of 8 and 16 years of age.
2. All required medical forms must be submitted by the applicant so that the camp
   medical staff can review all health issues and determine the camper’s suitability
   for admission to camp.
3. Applicants must have been seen by a rheumatologist regarding their rheumatic
   disease within the past 12 months.

4. Camper slots are first reserved for New Jersey residents and then residents of the
   Northeast region (NY & Eastern PA). If slots remain open, out-of-region applicants
   will be considered. If you are out-of-region, do not hesitate to apply as we have
   many out-of-region campers every year.
5. The applicant’s admission to camp will be in part based upon the receipt date of
   the application packet and medical forms. Registrations received by the stated
   deadlines will be given priority in the selection process.
6. Applicants will not be turned down due to an inability to pay all or part of the
   camp fee. Scholarships are available upon request for families in need of
   financial assistance.
7. Families must state their child’s need for camp in writing on the attached
   application. Eligibility is in part based upon the potential benefits the camper will
   receive from the camp experience.
8. The applicant will be chosen without regard to race, religion, gender, or ethnic
9. Applicants may be denied acceptance if they have had behavioral problems at
   camp in previous years.

APPLICANTS WILL NOT BE ADMITTED TO CAMP if their physical health or mental
health in any way endangers other campers and staff.

The Arthritis Foundation reserves the right to accept or deny applications on-site or
prior to attendance.
Camper Postcards
                  Camper Application Checklist
1. ______ Carefully read through the entire Camp CHAT application and note the
    dates and deadlines on your calendar.

2. ______ Fill out the application form (the next page) with all the required
    information and return it as soon as you are finished.

3. ______ Include the $50 registration fee or indicate that you are requesting a
    scholarship application. Please make checks payable to the Arthritis Foundation,
    New Jersey Chapter.

4. ______ Mail both the application form and $50 fee to:

       Arthritis Foundation, NJ Chapter
       ATTN: Camp CHAT
       555 Route 1 South, Suite 320
       Iselin, NJ 08830

•   Applicants who are not eligible for Camp CHAT will be notified upon receipt of
    their application and will receive their $50 fee back.

                  Important Dates & Deadlines
May 16th, 2011              Registration closes for all campers. Camp applications and
                            registration fees are due. A rolling application process
                            begins for any remaining camper slots.

June 1st, 2011              Campers will be notified of their eligibility and families
                            will receive the required medical forms.

June 15th, 2011             Due date for camp medical forms and final payments for

June 20th, 2011             Peer-Group-Leader-In-Training decision notification.
                          Camp CHAT 2011 Application Form

Please PRINT all information and return to the Arthritis Foundation by May 15th, 2011.
Camper slots are on a first-come, first-served basis so send in your application early!!

Camper First Name ____________________ Last Name _______________________ Sex ____

Address _______________________________________________ County ___________________

City ____________________________________ State _______ Zip ___________ Age ________

Home Phone ______________________________ Cell Phone ____________________________

E-mail Address ____________________________________________________________________

Date of Birth (mm/dd/yyyy) ____________________ Grade Completed by June 2011 ____

Parent/Guardian’s Name _________________ Parent/Guardian’s Name ________________

Rheumatic Diagnosis of Child ______________________________________________________

Rheumatologist’s Name/Location __________________________________________________

Date of Last Visit to Rheumatologist ______________

# of Years Attended at Camp CHAT _______________

Why does your child need and want to attend Camp CHAT?
Use reverse side or attach additional paper.

___ Registration Fee ($50 deductible from total camp fee) is enclosed. Checks should
    be made payable to the Arthritis Foundation, NJ Chapter. If the $50 deposit presents
   an issue please call Peggy Lotkowictz at 732-283-4300 ext. 319.
___ I wish to request a scholarship.

Do you want information on the PGLIT program? ________ Yes
(PGLIT = Peer-Group-Leader-In-Training program. Campers who are 16 or 17 years of
age are eligible to apply.)

Additional information and medical forms will be sent to you upon receipt of your
application form. Please return the application form and registration fee to:
                       Arthritis Foundation, NJ Chapter - Camp CHAT
                              555 Route 1 South, Suite 320
                                       Iselin, NJ 08830

*** Please make sure to flip over***

For Office Use Only   Application #___________ Date Application Received ___________
Why does your child need & want to attend Camp CHAT? Attach paper if necessary.











Is there anything specific your child needs to learn to enhance their knowledge about
their disease and how to manage it while at Camp CHAT?






Would your child be interested in bringing a musical instrument to Camp CHAT to play
with other musicians everyday?

No _______

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