[Nfbofsc] 2018 Fall SC Semior Camp letter, application and medical form

[David Houck]

July 20, 2018

 

Memo To:      Chapter & Division Presidents & Others

From: Frank Coppel, Director of Senior Camp

 

          Rocky Bottom Retreat and Conference Center of the Blind is a year
round facility available free of charge to the blind of South Carolina and
their family, located in the picturesque mountains of Pickens County in the
northwest corner of the state.  Rocky Bottom Retreat and Conference Center
of the Blind has been in operation since 1979, providing positive
recreational and educational programs designed to improve the quality of
life for blind persons of all ages.

            Rocky Bottom Retreat and Conference Center of the Blind is
pleased to announce its Fall Senior Camp, designed for legally blind adults
as 55 and over.  The camp will begin on Sunday, September 16, at
approximately 6:00 p.m. (supper provided) and end on Thursday, September 20,
2018 (breakfast provided prior to departure).  The camp is free of charge
and there will be a maximum of 25 campers.  Eligible campers who have never
participated will be given first priority.  Those eligible campers who have
not attended the most recent camp, will be given second priority, and any
other available spaces will be filled on a first-come, first-accepted basis.
WE ARE ENCLOSING A NEW MEDICAL FORM WHICH MUST BE FILLED OUT AND SIGNED BY
YOUR PHYSICIAN IN ORDER FOR YOUR APPLICATION TO BE PROCESSED. Since the 2018
Spring Senior Camp had to be cancelled, those individuals who were scheduled
to attend the Camp in May will be given priority and will only need to
submit an application for the Fall 2018 Senior camp.  Also, to ensure the
safe and efficient travel for everyone, the transportation service will pick
you up and return you only to your home address or address listed on the
application.  There will be scheduled activities including educational and
recreational programs, field trips and entertainment.  You will need to
bring personal money to use on field trips.

              There will be an opportunity to purchase Rocky Bottom
souvenirs.  To apply, please complete the enclosed application and return it
to the specified address, listed on the application.  You will be notified
of your acceptance.  All applications and MEDICAL FORMS must be returned to
the specified address in the application no later than Friday, August 17,
2018 to be considered for the Fall session of Senior camp.  If you need
additional registration and medical forms, you may make copies, or let us
know and we will be glad to provide them for you.  If you have any
questions, please contact me at (803) 796-8662, or email:
frankcoppel at att.net.  Please remember to send all of your members that are
55 years of age and older this information as soon as possible.  We hope to
see you at camp!

 

 

APPLICATION - ROCKY BOTTOM RETREAT AND CONFERENCE CENTER OF THE BLIND - Fall
SENIOR CAMP, September 16-20, 2018

 

Please complete and return no later than August 17, 2018 and mail to:

           Senior Camp

          Rocky Bottom Retreat & Conference Center of the Blind 

          119 S. Kilbourne Rd.

          Columbia, SC 29205

 

Name: _____________________________________ 

 

Male: ___ Female: ____  

 

Birthdate: ________________________________ Age: ______________

 

Address: _____________________________________________________

 

Primary Phone: ________________________ 

 

Alternate Phone: _______________

 

Name of Emergency Contact: __________________ 

 

Phone: ______________

 

We will need the enclosed medical form filled out and signed by your doctor
indicating that you are able to take care of your own personal needs.  We
will also need a list of your medications and allergies.  Your application
will not be processed without this information.

 

Transportation Arrangements

 

_____ returned to your home address (address listed on the application).

 

_____ Transportation will not be needed  

 

Signature ______________________________________

 

Eligibility requirements:  Must be legally blind and 55 or older.

Rocky Bottom Retreat and Conference Center of the Blind

Senior Camp Medical Form

 

The requested information must be completed by a licensed physician.

 

 

Name of Patient: ______________________________________________

 

Does this individual have any major health conditions the camp medical staff
would need to be made aware of, including food or drug allergies?  Yes___
No___

If yes, please list them here:

____________________________________________________________

 

____________________________________________________________

 

____________________________________________________________

 

____________________________________________________________

Note:  We will need to know of food allergies in advance to notify the
cafeteria staff.

 

____________________________________________________________

To the best of your knowledge, is this individual able to manage his/her
daily living needs   such as bathing, dressing, and feeding themselves?
Yes___     No___

Comments:

 

____________________________________________________________

Does this individual need assistance with administering any medication?
Yes___     No___

Comments:

 

____________________________________________________________

 

Signature of Physician__________________________________________

 

Date: _______________________________________________________

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