Camp ROAR Interest Form

Interest Form for Camp ROAR 2016- July 4 - July 8, 2016

PleaseĀ  copy and paste the below form with the responses to rdurban@asthmanc.com. Submissions of interest form will be time stamped and camp acceptance will be based on first come, first serve.

1. Participants name:

2. Participants date of birth (mm/dd/yr):

3. Grade level for 2016-2017:

4. Food allergy/medical diagnosis

5. Would you like to attend?

a. Name/age:

b. Name/age:

6. Guardian/Parent name:

7. Email address

8. Phone number:

You will be notified by March 24, 2016 that you have been accepted to camp (acceptance of siblings will occur on this date too). Registration packets will need to be completed and post marked by April 8, 2016 with the $25 fee per attendee enclosed and mailed to:

Asthma & Allergy Specialists, PA

Attn: Raquel Durban

8045 Providence Road

Suite 300

Charlotte, NC 28277

Thank you so much for your interest inĀ  Camp ROAR!

Here is the original post with all the information on the camp...

We are so pleased to announce that the Food Allergy Institute will be partnering with PAK for another great CAMP ROAR! We will also be applying for a FARE grant to support extra fun for our campers.

*** An interest form for this camp that you will submit via email will be posted on the Food Allergy Institute website and Facebook page, PAK Charlotte Facebook and Blog at 9am on Thursday, March 17. There are limited spots in camp that will be filled on a first come, first served basis. Completion of the form is the first step to register. Applications will be time stamped. Once the spots are full, children will be placed on a waiting list based on the time of completing the form. There will be a place to express interest in siblings attending, that will be available based on space***

Summer Youth Camp: Monday, July 4 through Friday, July 8, 9am-12:00pm (Cost: $25 per child) Pineville United Methodist Church 110 S. Polk Street, Pineville, NC 28134. This will be a drop-off camp for rising Kindergartners (5 years of age, on or before 8/31) through rising 8th graders. We will split into three age groups. We will secure a food allergy savvy nurse to serve as a volunteer. The campers will not know he/she is a nurse.

During camp, youth will have the opportunity to participate in typical camp activities such as arts/crafts and outdoor activities. Children will also participate in a variety of team building and group activities designed to encourage interaction with other food allergic youth. Topics covered during camp will vary based on demographics and needs of the group. Activities and small group discussions during camp will be centered around the topics below although these will likely vary based on the needs of the group.

Food Allergies 101, Challenges of Living with Food Allergies, Food allergies at home, school, camp, restaurants, etc., Food allergies in families, with friends, etc., Food allergies in the future, Facing the Challenge, Recognizing current strengths and resources, Tools and strategies to assist with these challenges, including: Peer and family relationships, Teasing/bulling, Stress and anxiety, Self management, Self advocacy

Top