Comprehensive Health Education Services, LLC

General Registration Information - Please READ Completely and Carefully before proceeding*

Rationale:

Hemophilia camp provides its attendees the opportunity to learn, grow and play with other peers. Children with an active inhibitor attending hemophilia camp find it difficult to relate to their “peers”, as their experiences dealing with hemophilia are so different and much more acute. The families of children with an active inhibitor may be fearful of sending their child to hemophilia camp due to the nature of their bleeding. Siblings often feel their needs are overlooked or put on the back burner. Inhibitor Family Camp is designed to provide these families respite, support, fun and real peer experiences from someone who understands each other.

How Do We Qualify?

Registration is on a first-come, first-serve basis for children and their immediate family members dealing with an active inhibitor. We're hoping to accommodate every family who wants to come, but space is limited. If there is a waiting list, preference will be given to families who have not yet had the opportunity to attend previous Inhibitor Family Camp programs. We encourage everyone to register so that we have your information should a slot open up. Children who have had a successful immune tolerance experience with no existing BU titer will be accepted as space allows.

The Registration and Travel Process:

Travel arrangements will be made upon FULL completion of all camp and medical forms. Your child’s physician will be responsible for partial completion of the forms. Space is limited, so the sooner the camp and medical forms are completed; the sooner Comprehensive Health Education Services can arrange your travel. You will NOT be allowed to complete any travel registration plans until you have received an email confirmation from CHES that your camp registration is completed. Each family member must depart from the same airport.

Absolutely NO campers will be allowed to come unannounced and/or unregistered.

Completed registrations are due by Friday, February 17, 2012. No new applications will be accepted after Friday, February 17th, 2012.

Each family is responsible for bringing their own factor products and ancillary supplies. There will be NO products or supplies provided by Comprehensive Health Education Services or The Painted Turtle. Sharps containers will be available at The Painted Turtle Infirmary.

Outlining the Registration Process

The following is an overview of how the registration process works. It can be divided into 3 main categories: 1) Pre-registration, 2) Camp Registration, and 3) Travel Registration. If you prefer, this page may be printed by selecting the printer icon on the top-right corner of the page.

1) Pre-Registration

To register for camp, you must first complete the pre-registration form. Upon approval, you will receive a confirmation email informing you to proceed with camp registration along with a password to access the registration forms. For more information on Inhibitor Family Camp qualifications, click here or go to the FAQ Page.

2) Camp Registration

Once you receive an email indicating that you and your family qualify for camp, you may begin the registration process by completing a series of online forms. It is not necessary for all forms to be completed at once, but each form must be completed in one sitting as answers will not be recorded until the "submit" button is clicked at the end of each form. Begin with STEP 1 and continue accordingly. You will need to use the password that has been provided in your confirmation email to access the forms for STEPS 1 and 2.

STEP 1: Inhibitor Family Camp Registration Form

This form consists of 5 parts, listed below. Certain portions of the form may require you to include additional documentation. Please make note of this as you fill out the form. You or your physician will have the opportunity to submit that documentation at the Upload Center. Completion times will vary, but on average should take about 15-20 minutes to fill out.

STEP 2: Weekend Family Members Medical Form

This form consists of 4 parts, listed below. The form must be completed for EACH family member who will be attending camp, excluding the primary camper (child with an active inhibitor). Similar to the previous form, you may be required to submit additional documentation. Please make note of these during the process. Estimated completion time: 5-10 minutes per entry.

The Five Parts include:

Primary Camper Info

Parent/Guardian Info

Family Members

Family Needs

Primary Camper Allergies

The Four Parts include:

Family Member Info

Pregnancy

Immunization History

Allergies

STEP 3: Confidential Campership Information Form

The Painted Turtle is made possible through generous donations and grants from public and private organizations. Please complete the following information, which helps their prospective donors evaluate their programs. This information is for demographic purposes only, and will remain anonymous and confidential. Only one entry per family. Estimated completion time: 1-2 min. (Optional)

STEP 4: Physician Forms

Medical forms and Immunization records must be completed by each camper's physician and returned to CHES before applications are considered as "complete". These forms can be accessed to download and print by clicking on the appropriate buttons below. Depending on age and inhibitor status, not all campers will be required to complete the forms. Please take note of the unique camper requirements per form.

To access the forms, you may do any of the following:

Print the forms and take them to your physician to be filled out, or

If you are unable to print them off, your physician may access and print them directly from our site

To submit the forms, you or your physician may:

Fax them to us at: (781) 878-8564,

Mail-in at: 80 Washington Street, Ste. D24, Norwell, MA 02061, or

Scan and email them to: info@inhibitorfamilycamp.org, or

Scan and send the files electronically by using our Upload Center

Note: The forms are due no later than Friday, February 17th.

STEP 5: Release Form

Every camper 18 years of age or older is required to sign the Authorization & Release form.

Please print off the form and have all appropriate persons sign it. If there are not enough signature spaces for all individuals 18 years or older, please print off and sign an additional form.

To submit, you may use any of the same methods used to send the required medical forms. Or, you may take the form to camp and hand it in personally.

Medical Forms

(To be completed by physician)

Required for all inhibitor

patients ages 6 through 19

Immunization Requirements

(To be provided by physician)

Required for campers under 18,

and inhibitor patients under 20

Severe Allergy Action Plan

(Completed by allergist, if necessary)

Required for campers who require

an Epi-pen for any allergy risks

Authorization & Release Form

(To be completed by campers)

Required for all campers 18 years

or older

3) Travel Registration

After all of the above-named forms have been completed, immunization records have been submitted, and your family members' physician(s) have turned in the required medical forms, your camp registration will be complete. Please allow us time to review all of your paperwork. Upon approval, you will receive an email notification to proceed with the Travel Registration Form. Families have the option of driving or flying to camp.

Driving:

In the event that your family is local to the area, or unable to fly for any reason, driving may be the preferred method of travel. You are welcome to drive and are encouraged to submit your mileage for reimbursement. (Completion of camp evaluations are required for mileage reimbursement.)

If you choose to drive, please be sure to complete the Travel Registration Form indicating your decision so that we may make the proper arrangements.

Flying:

CHES will managing all of your travel arrangements, including airfare to and from California, and all necessary ground transportation between the airport and The Painted Turtle. You will be asked to provide your preferred airline flights. After submission of your itinerary, we will contact you to verify your full completion of the registration process. When searching for flights on your favorite airline search engine, here are a few things to keep in mind.

The destination airport is the Los Angeles International Airport (LAX)

Try to arrive as close to 2pm as possible on Friday, April 13th (Camp is 1 1/2 to 2 hours away)

Try to depart no earlier than 3:30pm on Sunday, April 15th

Please have Flight Numbers, Airline Carriers, Departure Times, and Airport Codes available when providing flight information

We will try our best to reserve the flights that you request. In the event that we are unable to obtain flights to your preference, we will notify you as soon as possible for your new preferred flights.