OSSB Summer Camp Forms-2023

OSSB SUMMER CAMP 2023 REGISTRATION FORMS
Parent/Guardian Information
Name*

First NameLast Name
Email*
example@example.com
Phone Number*

Area CodePhone Number
Address:
Childs Name*

First NameLast Name
Childs Grade (going into 2023-2024 school year)
Students Birthdate
Childs Gender
Campers shirt size

Youth smallYouth mediumYouth largeAdult smallAdult mediumAdult largeAdult XLAdult XXLAdult XXXL

Camps registering child for: (All grades are going into for the 2023-2024 school year)

Advanced Cooking Camp (11th and 12th grade)June 6th-9th (Tues-Fri)Advanced cooking camp will help juniors and seniors continue to develop their cooking and dining skills. Campers will learn beyond the basics of cooking by planning, financing, shopping, and preparing meals. Campers will learn more about dining etiquette and expanding their pallet at restaurants in the Columbus area.

$30.00

Super Hero Camp (1st-3rd grade)June 6th-9th "Welcome to 'Superhero Camp'. During our week together we will explore Superheroes both real and make-believe, engage in stimulating "heroic" activities, delve into creative aspects of our "superhuman" selves, participate in STEM projects, and so much more! Your teachers will be Miss Mycah and Miss Traucht. We can't wait to fly through this fun-filled week with you!"

$30.00

STEM Camp (8th-12th grade)June 12th-16th OSSB 2023 Summer STEM camp is for students entering 8th – 12th grades and the theme of this year’s camp is “Animals”. Students will learn about different kinds of animals, their habitats and how they survive. Students will work both individually and in groups throughout the week, design an enclosure for animals and we also hope to have a few field trips.

$30.00

ECC Camp-Food and Numbers (3rd-6th grade)June 12th-16th This camp will focus on cooking and measurement skills to learn math through active student involvement and movement. The curriculum for the camp is based on Ohio's Learning Standards for mathematics, language arts, and physical education. Students will participate in learning activities, which will be reinforced through total body movement and active participation in the learning process. Math camp will include individual and group activities featuring cooking and outdoor events.

$30.00

Blind/Plus MD Day Camp (6th-10th grade)June 20th-23rd (Tues-Fri) Blind Plus Camp is a camp geared toward students with multiple disabilities. Our fun-filled week will focus on exploring our senses! Through academic and expanded core curriculum for the visually impaired, we will focus on exploration, social skills and daily living skills with a sensory theme. Activities will include music, movement, cooking, art and water play, with fun experiences in our community. Join us for a fun-filled week of camp!

$30.00

Theatre Camp (7th-12th grade)June 20th-23rd (Tues-Fri) Students in grades 7-12 will lean the basics of theater from reading and writing scripts, to front of house skills such as lighting, sound and stage directions. There will be an opportunity to visit a real theater and see a live performance during the week. Camp will conclude with a performance by the students.

$30.00

PE for Credit-2 Week ProgramJune 26th-30th and July 10th-14th Are you a non-OSSB high school (OSSB Student contact Mrs. Brewer-wood first) student who is need of obtaining your PE Credit? Are you also looking for opportunities to meet other students with visual impairments and also have the opportunity to stay in the dorms at OSSB overnight, participating in fun engaging evening activities? If so, this program is for you. If an OSSB student, please contact abrewer@ossb.oh.gov to make sure you qualify.

$ Free

MS Sports Camp (6th-8th grade)June 26th-30th Do you like making friends? Do you like being physically active and trying new activities? Then Sports Camp is for you! Sports Camp gives students the opportunity to get up and move. Past years have included archery, goalball, swimming, kayaking, soccer, biking, and so much more! Each year, the physical activities rotate, but no matter what the year, you're bound to have a good time. Join Mr. Grim and Mrs. Traucht for a week of fun and excitement!

$30.00

HS Sports Camp (9th-12th grade)July 10th-14thDo you like making friends? Do you like being physically active and trying new activities? Then Sports Camp is for you! Sports Camp gives students the opportunity to get up and move. Past years have included archery, goalball, swimming, kayaking, soccer, biking, and so much more!Each year, the physical activities rotate, but no matter what the year, you're bound to have a good time. Join Mr. Grim and Mrs. Kallstrom for a week of fun and excitement!

$30.00

STEM Career Exploration-National Science Foundation Partnership (9th-12th grade) This camp includes those seniors graduating this year.July 17th-21st Are you interested in STEM? In partnership, we are hosting a Nation Science Foundation Funded camp called the STEM Career Exploration Lab (CEL). The CEL camps include hands-on activities, such as assembling and using desktop 3D printers, using tactile 3D printed models, other tactile materials, and sound and kinesthetic activities, to teach astronomy, along with career-oriented interactions with STEM professionals with B/VI, and field trips to local businesses that afford insights into possible STEM careers.

$30.00

Horticulture Day Camp: My First Gardern (K-3rd grade)This camp will introduce students to gardening, we will be reading about gardening. We will learn about where our food comes from, what plants need to survive, the parts of the plant, how a seed grows, composting and harvesting plants. We will also be making recipes with plants from our greenhouse for us to enjoy! Campers will attend field trips to learn how the pioneers would grow crops and care for their animals. This will be a fun week that allows your child to get dirty and learn all about gardening.

$30.00

Braille Camp (8th-12th Grade)July 17th-21st Braille readers in rising grades 8-12 will use and improve their braille skills while discussing what makes a society truly accessible. Students will collaborate to find a problem and formulate a solution that is equitable for all. In addition, students will play braille games, socialize with other visually impaired teenagers, and enjoy fun competition.

$30.00

Braille Camp (3th-7th Grade)July 24th-28th ECC Camp will focus on various areas of the Expanded Core Curriculum for students who are visually impaired. Campers will learn to prepare meals and sharpen independent living skills. Campers will learn about standard and accessible technology and complete fun, educational projects related to all things technology. Students will also participate in activities related to vocational skill development, leisure, social skills, and communication.

$30.00

ECC- MS/HS (7th-12th grade)ECC Camp will focus on various areas of the Expanded Core Curriculum for students who are visually impaired. Campers will learn to prepare meals and sharpen independent living skills. Campers will learn about standard and accessible technology and complete fun, educational projects related to all things technology. Students will also participate in activities related to vocational skill development, leisure, social skills, and communication.

$30.00

Band Camp (7th-12th grade) Must be in band. If non-OSSB, must have approval from band director.July 31st-Aug 4th Students entering grades 7-12 have the opportunity to be a part of the only Blind Marching Band in the world! Students will practice marching fundamentals during this week-long camp and learn to march and play a halftime show. Students will travel to The Ohio State University to practice with the OSU Marching Band as part of the evening activities. At the end of the week, students will invite their families to watch the debut of the new halftime show!

$ Free

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You agree to pay the total amount above which will be invoiced to the email you provided above by March 31, 2023 to keep your campers spot in camp.*

Yes-I agree to pay with credit/debit card when invoice is emailed after registration submittedYes-I agree to drop off a money order to the school by March 30th, 2023
What is the campers home district?
Has the camper attended OSSB camp in the past?

YesNo
Does the camper take prescribed medications, related to medical conditions or allergies?

NoYes-I will indicate the medications on the medications form
Print the medication form below if your student takes prescribed medication. Return this to the OSSB nurses through mail or OSSBnurses@osdb.oh.gov or OSSBsummercamp@osdb.oh.gov
*Medication/Physical Forms- You agree to complete and return the required physical form (if applicable) as part of the registration process as well as the prescribed medication form (if applicable). You can find the medication/physical forms on the summer camp event page or on our school website. You may also email OSSBSummercamp@ossb.oh.gov if you need a copy.

Yes-I agree to return applicable physical/medication forms information by the due dateNo-All applicable physical and medication forms are due
If you are doing it by phone and can't print, would you rather this document emailed to you?

Yes, please email this documentIf an OSSB student, please send a paper copy home with my studentNA-My student does not take prescribed medication
Overnight Status:

My child will stay in the dorm (I understand I must pick up on Friday)My child will attend as a day student (I understand I must pick up at the end of camp)
Ohio State School for the Blind / Ohio School for the Deaf 2023 Summer Camp Consent

The Ohio State School for the Blind (“OSSB”) and the Ohio School for the Deaf (“OSD”) are committed to providing the highest level of educational and recreational experiences for all students attending our 2021 OSSB/OSD Summer Camps. Initial each paragraph below to indicate your consent and understanding.
Activities Consent: Your child may participate in a number of indoor and outdoor activities. We will provide constant supervision while your child is on campus and attending OSSB/OSD Summer Camp to minimize the potential for physical injury. I consent and approve of my child participating in recreational, educational, and independent living skills activities at camp. *
Initials
Medical Consent: I knowingly and voluntarily authorize the OSSB/OSD Summer Camp staff to procure such emergency medical, dental and optical treatment, as deemed necessary upon competent medical advice and which is in my child’s best interest if I am unavailable to give my consent. I understand and accept that in the case of an emergency, that OSSB/OSD will make every effort to notify me in advance of the treatment of any serious medical, dental or optical issues affecting my child. OSSB/OSD will not be held liable for the performance of such medical care, which will be provided only by a licensed medical professional. I understand that I will be responsible for the cost of any such medical, dental or optical treatment provided to my child. Initial below:*
Initials
Photo and Video Consent: I understand that OSSB/ OSD Summer Camp programs may take photographs or videos of participants at camp. I give permission for my child to be photographed and/or videotaped while they are at camp for public relations and educational purposes. I understand and give my permission that identifying information may be given to the media or used for publicized activities relating to my child’s participation at camp.*
Initials
Transportation Consent: I understand that portions of OSSB/OSD Summer Camp will take place in the local community. I give permission for certified camp staff to provide transportation using a state vehicle or school bus during these trips.*
Initials
Property Consent: I understand that OSSB/OSD is not responsible for lost, stolen or damaged personal property that my child may bring to camp.*
Initials
Camp Code of Conduct Consent: I agree that I have read through, understand and agree that my child and I will be held to the Camper Code of Conduct below. I also agree that I have reviewed the Camp Code of Conduct with my camper(s).*
Initials
Parents Name (Print)*

First NameLast Name
Parent/Guardian Camp Consent Signature*

Clear
Parent/Guardian Camp Consent Signature Date*

MonthDayYear
Date
Camper Code of Conduct Agreement:

1. I agree to pay attention and actively participate in camp activities.

2. I understand that there is no cell phone or text phone use during camp activities. Staff may ask students to leave in their book bag, locker, or dorm until camp is over, if needed.

3. I understand that my parent will be contacted to pick me up if my behavior becomes disruptive.

4. Illegal drugs, alcohol, theft, bullying (directly or through social media) or sexual behavior is not allowed at OSSB/OSD.

5. I will cooperate with camp staff.

6. I will wear clothing appropriate for camp at all times. Clothing with words or pictures that are related to drugs/drug use, tobacco, alcohol/alcoholic beverages, sexual references violence or bigotry are not permitted. Any attire or statement that may cause a hostile, intimidating, degrading, offensive, harassing or discriminatory environment is prohibited.
Camper Code of Conduct Agreement Camper Signature:*

Clear
Camper Code of Conduct Agreement Camper Signature Date:*

MonthDayYear
Date

Section 2: Parent/Guardian & Emergency Contact Information
Learning Media Form
Student Name*
School Information:
Current School Instructor or Contact*
Current School District Attending*
Current School Phone Number*
What name does your child like to be called?
What type of technology or adaptive equipment does your student use?*
What level of Braille skills does your student presently have? Insert NA if not applicable.*
How long has he or she been a Braille reader? Insert NA if not applicable.*
What is your child's present reading level?*
What is your child's present math level?*
What are your child's favorite subjects?*
What subject(s) does your child perform best academically?*
Please mark all the Learning Media your student uses:*

BrailleLarge PrintRegular PrintAudio Materials

Learning Media Form
Health Information:
Cause of Visual Impairment or Blindness (if known)
Visual Acuity of the Left Eye
Visual Acuity of the Right Eye
Additional Disabilities: (Please explain)
Allergies (include reactions to specific foods) Insert NA if not applicable.*
Medications (Complete Medication form separately)
Mobility Information
Please check one, which most closely describes your community:*

RuralUrbanSuburban
Are you aware of any orientation or mobility needs that the student has which arepresently not being met or planned for?
Please list any mobility or low vision aids that your child uses. (If equipment is owned or on loan, please bring with you to summer program).

Section 4: Medical Information Details
1. My child has the following known food, medication and/or environmental allergies (please include reaction, like; rash, difficulty breathing):
2. My child has the following activity restrictions:
3. Medical Conditions or other important health issues (asthma, seizures, diabetes):
*An Action Plan from a healthcare provider is REQUIRED for all asthma, diabetes, seizure, and severe allergic reaction diagnoses.*
Section 5: Dietary Needs

(Physician’s orders are REQUIRED for Restricted diets and/or tube feedings)
Regular Diet

No Restrictions
Regular Diet-Food Consistency

Finely ChoppedChoppedPureeCut in small bites
Restricted Diet: Physician’s order MUST accompany all restricted diet orders and enteral tube feedings. Description below:
Please select if applicable: My child's diet is:

VegetarianVeganNo pork
Tube Feeding: Physician’s order MUST accompany all restricted diet orders and enteral tube feedings. Description below:
I have completed ALL 5 Sections of the Emergency Medical Form. Sign Below.*

Clear
Date*

MonthDayYear
Date

	Allergy	Reaction
Allergy 1
Allergy 2
Allergy 3
Allergy 4
Allergy 5

	Medication Name	Dose/How Much	Frequency/How often	Time of Day	Prescriber
Medication 1
Medication 2
Medication 3
Medication 4
Medication 5
Medication 6
Medication 7
Medication 8
Medication 9
Medication 10

OSSB SUMMER CAMP 2023 REGISTRATION FORMS

Parent/Guardian Information

Ohio State School for the Blind / Ohio School for the Deaf 2023 Summer Camp Consent

Section 2: Parent/Guardian & Emergency Contact Information

Learning Media Form

School Information:

Learning Media Form

Health Information:

Mobility Information

OSSB EMERGENCY MEDICAL FORM

Section 1: Student Information

Section 2: Emergency Contact Information

Section 3: Medical Treatment Authorizations

Section 4: Medical Information Details

Section 5: Dietary Needs

Over the Counter Medication Consent