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 participant 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 participants 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 participant's daypack and that pocket is marked with a bright ribbon so that staff can easily access it. Participants 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 participants with food allergies attend SEACAMP every year and we have yet to have an incident involving accidental ingestion. However, participants 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 participants with food allergies. However, some participants with more severe limitations may require a level of risk management beyond what we can provide. If this was the case, we can discuss options regarding food and participation. Please complete information below regarding the participant’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.). Participant First Name * Participant Last Name * Name of School/Group * Specific food allergy(s) * Peanut Allergy Tree Nut Allergy Dairy Allergy Celiac Disease Gluten Allergy/Intolerance Seafood or Shellfish Allergy OtherOther Dairy Free & Gluten Free Meals Information Dairy free, gluten free meals are 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 under the "Additional food allergy(s) information" section. We strongly recommend participant bring some favorite allergen friendly snacks, desserts, and other supplemental items to ensure participant has additional options, if needed. Any supplemental food should be individually wrapped and in a bag labeled with the participant's name. Items will be collected on the first day of camp and stored in our small on-site kitchen. Is participant prescribed an Epi-Pen for food allergy(s)? * Yes No Is participant prescribed an Inhaler for food allergy(s)? * Yes No I undertstand that participant is required to bring prescribed Epi-Pen and/or prescribed Inhaler with them to camp session. * Yes, I understand Will participant bring Benadryl for food allergy(s)? * Yes No Provide additional information regarding food allergy(s) including signs or symptoms in the case of an accidental ingestion and suggested care plan in case of an accidental ingestion. * Date of last accidental ingestion double check that year is correct Severity of last accidental ingestion Is participant able to eat in restaurants? * Yes, participant is able to eat in restaurants No, participant is not able to eat in restaurants Student Not Able to Eat in Restaurants If the severity of the student's allergy does not allow them to eat in restaurants, even when student is selecting meals/foods that do not include their specific allergen/intolerance, the student/family 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. Considering the severity of the participant’s peanut allergy, would you like to request that no items with peanuts be offered to the other participants attending? * Yes, I request that no items with peanuts be served to other participants for the duration of the camp session No, items with peantus may be offered to the other participants attending camp session We have noted that you are requesting no peanuts be served by our caterer for the duration of your student's camp session. Please note, fellow students often bring their own snacks with them to camp. If restrictions regarding snacks are needed, please reach out to your school/group representative to coordinate. Considering the severity of the participant’s tree nuts allergy, would you like to request that no items with tree nuts be offered to the other participants attending? * Yes, I request that no items with tree nuts be served to other participants for the duration of the camp session No, items with tree nuts may be offered to the other participants attending camp session We have noted that you are requesting no tree nuts be served by our caterer for the duration of your student's camp session. Please note, fellow students often bring their own snacks with them to camp. If restrictions regarding snacks are needed, please reach out to your school/group representative to coordinate. Considering the severity of the participant’s dairy allergy, would they be able to choose their desired sandwich from the options provided and remove the cheese? Yes, participant will be able to choose from the provided sandwich options and remove the cheese No, participant will need a cheese free sandwich provided Considering the severity of participant's seafood allergy, will the student be able to touch marine animals at camp or in the field without risk of reaction? * Yes, participant is able to touch marine animals. No, participant is not able to touch marine animals Participant 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 participant be brining supplemental food items to camp? * Yes, participant will be bring supplemental food items No, participant will not bring supplemental food items Participant Supplemental Food Any supplemental food should be individually wrapped and in a bag labeled with the participant's name. Items will be collected on the first day of camp and stored in our small on-site kitchen. Participant is a student or adult? * Student Adult As the parent/guardian of above student * I verify the above information provided is true and accurate. l further verify that 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 * As the participant * I verify the above information provided is true and accurate. l further verify that 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. Submit If you are human, leave this field blank.
