OFFICE
Invent Now, Inc.
3701 Highland Park NW
North Canton, OH 44720
Location Name
Street Address
City, State Zip
Program Name
Program Code
Start Date through End Date
Start Time to End Time
PHONE
800.968.4332
EMAIL
[email protected]
Parent Name
Street Address
City, State Zip
WEB
campinvention.org
DEAR PARENT /GUARDIAN,
Thank you for choosing Camp Invention and investing in your child’s future!
Camp is just around the corner and we cannot wait to see your child there
in a few weeks. We know Camp Invention will be your child’s favorite part
of the summer!
Enclosed you will find important paperwork including:
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Program Information
I Can Invent™: Take Apart Waiver
Acceptable Take Apart and upcycle materials list
Participant Information Form
Please fill out these forms and bring them with you on the first day of Camp.
You must have these completed in order to participate. Note that these forms
require the signature of both parents or legal guardians.
If you have any questions or concerns, please do not hesitate to call us at
800.968.4332 or email us at [email protected].
We thank you for your commitment to your child and your involvement in the Camp
Invention experience.
–The Camp Invention Team
“As prototypes unfold, they allow you to work on things, they allow you to make changes—prototypes don’t often work,
they break, they change, you have new ideas. You have to manipulate them a lot. Your prototype has to be flexible.”
- Steve Sasson, Inventor of the Digital Camera and 2011 National Inventors Hall of Fame Inductee.
© 2014 Invent Now, Inc. All Rights Reserved
WHAT YOU CAN DO TO IMMEDIATELY HELP PREPARE YOUR CHILD FOR CAMP
yy If your child has any special needs, such as diabetes or severe allergies that warrant the administration of epinephrine,
please call 800.968.4332 as soon as possible to make necessary arrangements;
yy Identify and prepare your child’s Take Apart item in accordance with the guidelines on the next page;
yy Start collecting materials to upcycle. These materials will be shared by all camp participants and placed in the
Inventors Supply Room. Look for guidelines on the next page.
WHAT TO BRING TO CAMP
yy A packed lunch, beverage and snack clearly labeled with your child’s name every day;
yy A completed Participant Information Form and Take Apart Waiver;
yy An eligible and prepared Take Apart item clearly labeled with your child’s name. Feel free to bring more than one item for your
child to take apart. Keep in mind that children have fun trading their Take Apart item’s components and pieces;
yy Materials to upcycle and share throughout the week of camp. The more you bring, the better experience for your child.
WHAT YOU CAN DO TO FACILITATE AN EASIER CHECK-IN ON THE FIRST DAY
yy Please plan to arrive 30 minutes early on the first day of the program with your child’s Take Apart item, materials to upcycle and
completed Participant Information Form;
yy Your child should be dressed in comfortable clothes and shoes – no flip-flops please;
yy You, or an authorized individual, are required to sign your child in and out daily.
ADDITIONAL INFORMATION
Your child’s Camp Invention experience is just as important to us as it is to you. You will receive a Daily Newsletter by the end of
each day to keep you updated throughout the week of camp. The newsletters will provide you with more information about the
concepts your child is learning during the week of your program.
The Daily Newsletter is also meant to encourage conversations with your child about his or her experience, so we share trivia
questions, fascinating tidbits and activities that will help your family keep up the spirit of camp at home.
At the end of the week, you’ll be invited to attend the Inventors Showcase, a time dedicated for you to view what your child created
this week: prototypes of inventions. Of course, the prototypes may not be functional, but like all prototypes, they’ll represent a
bigger idea, so be sure to ask your child about their invention. In order to allow all children to create their best possible invention,
we encourage teams to learn from mistakes, brainstorm and work together. During the Inventors Showcase, you’ll experience how
these ideas and concepts come together.
Please remember that your child’s work is more than just boxes and tape; it’s a tangible representation of his or her
own creative thinking skills. By looking at the bigger picture, you might just learn something new, too!
© 2014 Invent Now, Inc. All Rights Reserved
SELECTING AND PREPARING
YOUR CHILD’S TAKE APART ITEM
IDENTIFYING AND COLLECTING
ITEMS TO UPCYCLE
Over the last 20+ years, the I Can Invent™ module, featuring hands
on reverse engineering activities, has been one of the most enriching
and entertaining portions of our programs. Children are asked to bring
a used/broken appliance item from home. They will be instructed in
the safe use of hand tools and then guided through the Take Apart
portion, where they disassemble the appliance. In teams, the children
will begin the process of creating a new invention using the parts from
within the item.
Help us allow your child’s imagination run wild throughout the program
by collecting upcyclable materials for your child to use and share.
These items are very important for this week of camp, as they help
children design their prototypes. Please refer to list below when
determining whether an item is acceptable or unacceptable.
In preparation for the program, help your child to acquire a broken
or unusable household appliance or other mechanical device for him
or her to take apart during the I Can Invent™ module. Also, you can
visit local second hand stores to find Take Apart items to bring to
camp. Please refer to the items below when determining whether the
appliance is appropriate. During the I Can Invent™ module, children will
work in teams to brainstorm and create.
ACCEPTABLE ITEMS FOR UPCYCLING
It is extremely important that you prepare your child’s
Take Apart item prior to the week of the program.
Carefully unplug and cut all electrical cords and place the item in a
bag clearly labeled with your child’s name. Be sure to remove all other
components that may potentially cause harm, including glass, blades
or heating components. This will not only provide for an additional
degree of safety but will allow your child more time to have fun
investigating their Take Apart’s inner gear and gadgets.
IMPORTANT: To view a more comprehensive list of recommended Take Apart and
recyclable materials please visit: campinvention.org/parents/resource-center. Please
be advised that the Take Apart item you provide will not be returned to you in working
condition. Children will work in groups to disassemble their items to be used in a
group project.
ACCEPTABLE TAKE APART ITEMS
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CD players
Computer towers/Hard drives
Digital clocks
DVD players
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Keyboards
Stereos and radios
Tape decks and recorders
VCRs
UNACCEPTABLE TAKE APART ITEMS
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Blow dryers
Cameras
Cell phones
Coffee machines
Irons
Laptop computers
Microwaves
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Monitors
Printers
Rotary phones
Televisions
Toasters
Vacuums
Video game consoles
IMPORTANT: Please thoroughly wash out all bottles, containers, foam trays
and any other items as needed.
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Beads, buttons and craft supplies
Boxes (shoe, cereal, etc.)
Bubble wrap
Building blocks
CDs
Containers/lids
Fabric
Film canisters
Foam trays
Game parts
Miscellaneous paper (magazines,
newspaper, kraft etc.)
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Milk /OJ cartons /jugs (rinsed)
Oatmeal canisters
Paper towel tubes
Pinwheels
Plastic bottle caps
Pulleys
Rubber bands
Springs
Sporting goods and balls
(no golf clubs or bats)
yy Strainers
yy String
yy Washers
UNACCEPTABLE ITEMS FOR UPCYCLING
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Batteries
Cords
Glass
Glitter
Liquids
Medicine containers
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Packing peanuts
Paint
Prescription bottles
Soda pop cans
Wire hangers
For safety purposes, your child’s Take Apart item will be screened
by an Instructor for acceptance prior to the program’s start. If you
have any questions as to whether an item is acceptable either as a
Take Apart or as an item to upcycle, please call the Invent Now home
office at 800.968.4332. Invent Now is not responsible for lost or
stolen goods.
© 2014 Invent Now, Inc. All Rights Reserved
TAKE APART ITEM WAIVER
At Camp Invention, we want your child’s experience to be educational, engaging and most importantly, safe. During the next few days, while the
class is well supervised, participants will be involved in our Take Apart module, which carries with it an increased risk of injury when children are
working on objects from home that may have pinch points, sharp edges, etc.
As a result, Camp Invention has decided to offer you two (2) options:
Full Participation – This means you are approving your child to attend the I Can Invent™ module and use, with supervision, common hand tools to
disassemble the used/broken appliance you send for camp. By checking the “Full Participation” option below, you are acknowledging there is an
increased risk of injury and releasing Camp Invention from liability.
Partial Participation – This means you are opting your child out of the Take Apart portion of the I Can Invent™ module. They will help their
teammates by designing the construction of their group invention. Your child will be wearing the same safety gear as those doing “Full Participation”
but tasks for these children will not be mechanical and they will not be allowed to handle the Take Apart tools nor disassemble any items.
Please select the option below you believe is best for your child and turn in this signed form with your completed Participation Information Form
(enclosed in this mailing) on the first day of camp. If you do not return the form, we will assume that you choose the Full Participation option.
❏❏ Full Participation
❏❏ Partial Participation
Parent/Guardian Signature
Date
Parent/Guardian Signature
Date
Name of Participant
Location of Program
ACCEPTABLE BEHAVIOR POLICY
It is important to Camp Invention that all campers receive a positive and rewarding experience while attending our program. In order to ensure a
safe and fun environment for all, children are expected to behave in an acceptable manner and use appropriate language. ANY behavior deemed
to be detrimental to or in violation of Camp Invention standards will be dealt with by the staff and/or Director. Unacceptable behavioral instances
include, but are not limited to: any form of intended harm to another camper or staff member, bullying or any form of aggression.
Any situation that involves distracting other participants or disrupting camp activities will not be tolerated. It is important to remember that there are
NO REFUNDS if a child is asked to leave Camp Invention due to unacceptable behavior. By paying your registration fee in full, you signify that you
understand and agree to the Acceptable Behavior Policy.
I have read and will abide by the Camp Invention rules. I understand that Camp Invention staff have the right to remove any person from the
program that does not abide by these rules. If I am asked to leave, I understand that my tuition is nonrefundable.
Parent/Guardian Signature
Parent/Guardian Signature
Child Signature
© 2014 Invent Now, Inc. All Rights Reserved
PARTICIPANT INFORMATION FORM
CHILD INFORMATION
LIABILITY WAIVER
MUST be signed in order for your child to participate.
Child’s Name
Camp Invention is a safe environment. You can have full confidence
that precautions will be taken to ensure the safety of your child and
that your child will be supervised by adults during the week of your
program. However, you must sign this waiver in its original form,
without alterations, for your child to participate.
Date of Birth
Program Location
CityState
Zip Code
Grade Level Next Fall
PARENTS/GUARDIAN INFORMATION
Parent/Guardian Name
Parent/Guardian Name
Street Address
CityState
Zip Code
Primary Parent /Guardian Home Phone Number
Primary Parent /Guardian Work Phone Number
Primary Parent /Guardian Cell Phone Number
I am the parent/legal guardian of (“child”). On my own behalf and as parent and guardian, I
acknowledge and agree that there is the possibility of physical
injury or loss associated with my child’s participation in the Camp
Invention program (the “Camp Invention Program”). I hereby release,
discharge Camp Invention, its affiliated organizations, employees
and associated personnel including the owners of the camp facility
against any and all claims, liabilities and/or damages as a result of
my child’s participation in the program, including but not limited
to, any claim that Camp Invention was negligent. I further agree to
defend and indemnify Camp Invention, its affiliated organizations and
employees and associated personnel if any claim is made against
them by or on behalf of my child. I understand that my child will not
be permitted to participate in the Program without my signing this
Agreement. Finally, I acknowledge that Camp Invention is an Ohio
organization and I agree that Ohio law will govern the interpretation
and validity of this liability waiver.
Parent/Guardian Signature
Date
Parent/Guardian Signature
Date
ALTERNATIVE CONTACTS/
TRANSPORTATION ARRANGEMENTS
In the event of an emergency, I authorize the following individual(s)
to pick up my child from the program
Name/Relationship
Phone Number
Name/Relationship
Phone Number
My child may:
Walk and/or Ride his/her bicycle home
PHOTOGRAPHY RELEASE
I authorize the Camp Invention program to obtain, store and/or use
(without payment) any photographs, slides and/or videotapes of
my child for public relations, marketing/advertising and/or internal
training purposes.
Parent/Guardian Signature
Date
Parent/Guardian Signature
Date
Parent/Guardian Signature
Date
Parent/Guardian Signature
Date
© 2014 Invent Now, Inc. All Rights Reserved
EMERGENCY MEDICAL CONSENT
In the event that reasonable attempts to contact me and the two
alternate individuals that I have designated at the phone numbers
that I have provided on this form have been unsuccessful, I hereby
give my consent for the administration of any treatment deemed
necessary by the physician, dentist and/ or hospital, as applicable,
listed below:
Preferred Physician
Preferred Dentist
Phone Number
Preferred Hospital
Phone Number
List any special needs, important medical history/behavior and/or
accommodations that can be made to make your child’s experience
more successful:
y child is carrying an inhaler and is authorized to self-administer
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as needed. (Physician’s order has been completed at the bottom
of this form).
Phone Number
y child is attending with an epinephrine injection to be
M
administered in the event of a severe allergic reaction.
IMPORTANT: Epinephrine administration forms must be completed by
parents and the physician. The Director must be trained by the parent in the
administration of the epinephrine injection prior to the start of the program.
Parents of participants with such severe allergies and other special needs
must call 800.968.4332 to acquire these forms and begin making the
necessary arrangements.
In the event that the designated preferred physician, dentist and/or
hospital, as applicable, is not available, I hereby give my consent for
the administration of any treatment deemed necessary by another
licensed physician or dentist at any hospital reasonably accessible.
This authorization does not cover major surgery unless the medical
opinions of two other licensed physicians or dentists (as applicable),
concurring in the necessity for such surgery, are obtained before
surgery is performed.
Parent/Guardian Signature
Date
Parent/Guardian Signature
Date
EMERGENCY MEDICAL REFUSAL
I do not give my consent for emergency medical treatment of my
child. In the event of illness or injury requiring emergency treatment,
I wish the school authorities to take no action or to:
PHYSICIAN’S ORDER FOR PRESCRIBED
ORAL MEDICATION
All medication must be delivered in the original container in which
it was dispensed and administered by a pre-authorized individual
designated by the parent/guardian. No member of the Camp
Invention program is permitted to administer medication.
I have arranged, and hereby authorize, the administration of
prescribed medication for my child to be handled as follows:
Name of Medication
Dosage
Name of Authorized Individual
to Administer Medication
Date(s) and Time(s)
of Administration by
aforementioned individual
Name of Issuing Physician
Issuing Physician Emergency
Phone Number
Significant side effects (adverse reactions) that should be reported
to the physician:
Do not sign if Emergency Medical Consent was authorized above.
Parent/Guardian Signature
Parent/Guardian Signature
Date
Date
PARTICIPANT MEDICAL INFORMATION
Issuing Physician Signature
Date
Parent/Guardian Signature
Date
Parent/Guardian Signature
Date
Allergies (food, medication, etc.): Activity restrictions or precautions: List any medication child is currently taking: © 2014 Invent Now, Inc. All Rights Reserved