Food Allergy Form - School Year Food Allergy Form - School Year Food Allergy Information Statement SEACAMP San Diego uses a catering service to bring meals on-site from their kitchens. Breakfasts and dinners are usually cafeteria-style meals and lunches are “brown-bag”-style usually eaten in the field. SEACAMP is willing to work with allergies/special diets, but there are limitations to our catering service and food preparation at camp. Please be aware that our caterer uses peanuts/tree nuts, gluten, soy, dairy and fish/shellfish products in its kitchens. As tolerance levels vary widely, we take student allergies on a case-by-case basis. We are able to request no tree nut or peanut products for the entire group for the length of the session, for students that cannot tolerate nuts in their vicinity. Unfortunately, a gluten-free diet/environment for an entire group is currently not a possibility. Emergency remedies in case of accidental ingestion (Benadryl or an Epi-pen) will be stored in a specific pocket in the child's daypack and that pocket marked with a bright ribbon so that staff can easily access it. Students will be responsible for their own food choices. SEACAMP will not be monitoring intake at mealtimes. We need parents to talk their student about all the arrangements made for meals during their student's stay, and to encourage student to come to our staff with questions or concerns about food choices. Many students with food allergies attend SEACAMP every year and we have yet to have an incident involving accidental ingestion. However, students extremely limited in options should bring "safe" foods they like, to make up for not being able to have the same food choices as the other students. Additionally, we do our best to accommodate students with food allergies. However, some students with more severe limitations may require a level of risk management beyond what we can provide. We are happy to waive our cancellation policy and refund any family their tuition in full if it has been determined this is the case. Please complete information below regarding your student’s specific allergy. Be specific! It is helpful for SEACAMP staff to know if there are exceptions/specific situations that change the food plan (i.e. milk or milk products in baked goods are OK, milk drunk straight not OK, etc.). Student First Name * Student Last Name * Name of School/Group * Specific food allergy(s) * Peanut Allergy Tree Nut Allergy Dairy Allergy Celiac Disease Seafood or Shellfish Allergy OtherOther Dairy Free & Gluten Free Meals Information Dairy free, gluten free meals is a difficult combination for our caterer to provide, as it is very restrictive in our camp environment. Please provide detailed information on what the student can and cannot eat. We strongly recommend student bring some favorite allergen friendly snacks, desserts, and other supplemental items to ensure students has additional options, if needed. Any supplemental food should be individually wrapped and in a bag labeled with your student's name. Items will be collected on the first day of camp and stored in our small on-site kitchen. Additional food allergy(s) information Date of last accidental ingestion double check that year is correct Severity of last of accidental ingestion Signs and symptoms in the case of accidental ingestion * Suggested care plan in case of accidental ingestion (i.e. Benadryl, Epi-Pen). Student must bring own prescribed Epi-Pen to camp, if needed * Student must bring own prescribed Epi-Pen to camp, if needed. Specify dietary requirements * Is the student able to eat in restaurants that serve or make foods with this allergen, assuming student is selecting food without allergen/intolerance? * Yes No Student Not Able to Eat in Restaurants Students that are not able to eat in restaurants will need to provide all of their own meals. SEACAMP caterer will not be able to feed those students. If this is an issue or if you have any questions, please call 1-800-SEACAMP. Does the student need to be isolated at mealtimes at school or other public places to avoid contact/airborne particles of the allergen (i.e. seating at a “nut-free” table)? * Yes No Does the student’s individually wrapped lunch meal need to be isolated from the other students' individually wrapped lunch meals (not transported in the same tray)? Currently only possible for peanut or tree nut allergies. * Yes No Will the student be able to touch animals at camp or in the field without risk of reaction? * Yes No Student Not Able Touch Animals SEACAMP will provide nitrile gloves for labs. Gloves for in-water activities must be provided by student/family, if needed. If these precautions are not sufficient, please contact the office at 1-800-SEACAMP. Will student be brining supplemental food items to camp? * Yes No Student Supplemental Food Any supplemental food should be individually wrapped and in a bag labeled with your student's name. Items will be collected on the first day of camp and stored in our small on-site kitchen. Please list supplementary food items the student will be bringing to camp, if needed Parent/Guardian Signature Electronic Signature Consent I Accept - by selecting “I Accept,” you are signing this Agreement electronically. You acknowledge you have read and understand the above terms, and you agree your electronic signature is the legal equivalent of your manual/handwritten signature on this Agreement. By selecting "I Accept" using any device, means or action, you consent to the legally binding terms and conditions of this Agreement. You further agree that your signature on this document (hereafter referred to as your "E-Signature") is as valid as if you signed the document in writing. Click here for the full Electronic Signature Consent agreement. As the parent/guardian of above student who is now a minor: * I verify the above information provided is true and accurate and affirm that I am at least 18 years old with my signature below. I further verify that I have I have read the SEACAMP San Diego Food Allergy Information Statement regarding catering and food arrangements at camp and I understand limitations to arrangements and facilities. Parent/Guardian Name * Parent/Guardian Signature E-Signature * Clear Date of E-Signature 05/18/2022 If you are human, leave this field blank. Submit
