Project COMMON BOND 2014
A Tuesday’s Children Program
Dear Parent and Participant,
Congratulations on being accepted to participate in Project COMMON BOND 2014!
Your presence will offer yet another unique contribution to enhance the experience of all of the diverse participants
who are joining us. Our hope is that all participants will have fun, make new friends, feel a part of a remarkable
community, and learn more about themselves and those from other cultural backgrounds.
We aim to accomplish this goal by creating a range of experiences throughout the week. After breakfast, each day will
begin with a session on exploring dignity and the essential role it plays in conflict resolution. So as not to be repetitive,
each year the program is updated with new material. After lunch, there will be a schedule of activities including art,
music, movement, theater and sports that your son/daughter can choose to participate in. The evenings will be filled
with special programs and recreational down time. Project COMMON BOND 2014 will be conducted in Madrid,
Spain.
In addition to letting you know about the structured activities that your son/daughter will be taking part in, we also
wanted to try and convey some of the process that unfolds over the course of the week, so that you will be better
attuned when your son/daughter reunites with your family.
Looking at past PCB years, it is clear that as the week progresses, participants become more connected, feel a sense of
safety and rapport, and often elect to share some of their personal experiences of loss. We expect this and provide a
comfortable space and time to sanction that sharing. We will have a team of clinicians who are experienced in working
with teenagers and the issues around trauma, grief and loss. This sharing is not intended to be therapy or to function as a
therapy group; however, the organic process that allows the participants to choose to open up emotionally often has the
effect of being therapeutic/healing.
The young men and women, who participate in Project Common Bond, arrive with many stories to tell.
We spend a significant amount of time in the beginning of the week setting ground rules for creating a respectful
environment. Not everyone chooses to share their personal experiences, and that is understood.
However, being “witness” to others as they choose to express themselves is a powerful contribution.
Each participant senses the commonality that they share with others at PCB, and that forms the basis for a deep and
profound safety and connection. As this personal sharing begins to happen, you can almost feel a group wide release of
renewed energy. Our hope is that this sharing of personal narratives and the renewal of energy that does occur might
prompt participants to new awareness of how they can be agents of change within their lives going forward.
Finally, you can expect a continuum of responses when your son/daughter returns home.
We have heard parents say that their son/daughter was quiet and less forthright with their experience, or that they were
sad and missing the PCB friends, or that they were thrilled to be home and eager to move on with their summer. All of
these responses are normal and typical for the transition from Project COMMON BOND to home. All of us at PCB,
staff and participants alike, discover that it takes time to fully integrate the whole of the experience.
We hope this helps you to anticipate your son/daughter’s experience with us. Please feel free to contact us if you have
any further questions.
Kathy
Participants from a new country:
(not listed in the returning countries category)
Returning Participants:
(from the following countries: Algeria,
Argentina, Croatia, France, Indonesia, India,
Israel, Ireland, Liberia, Morocco, Nigeria,
Northern Ireland, Palestine, Russia, Spain, Sri
Lanka, Kenya, Pakistan, United Kingdom,
USA)
 All Visas must be completed by June 30th, 2014
 Coming from a first time participating country
your Project COMMON BOND 2014 program
fees and travel arrangements to Madrid, Spain
are being waived.
 Contact Aja Minor for travel arrangements at
Aja@tuesdayschildren.org
 All visas and travel arrangements must be
completed by June 30th, 2014.
 Participant is responsible for all costs associated
with travel.
 Contact Aja Minor for travel information at
Aja@tuesdayschildren.org.
All of the following forms
must be completed and returned
by June 6, 2014 to:
Tuesday’s Children
390 Plandome Road, Suite 217
Manhasset, NY 11030
Phone: 516-562-9000
Fax: 516-627-4736
kathy@tuesdayschildren.org
If there is financial hardship, please contact Kathy 516.562.9000 for a confidential conversation.
 Please include 2 pictures of your child.
 Please read and sign with your child the enclosed letter regarding Project COMMON
BOND rules.
 Promptly fill out our Medical Forms.
 We have a strict peanut aware policy – please read and abide by these rules for the health
and well being of our participants.
We would like to take this opportunity to welcome you to this exciting program and pledge to do
our utmost to make this experience the most meaningful and positive experience possible for your
children. If you or your teenager have any questions, suggestions, feedback or concerns prior to or
during the week, please do not hesitate to contact us.
Our commitment is to ensure the happiness, safety, health and comfort of everyone attending
Project Common Bond 2014. If you have any financial hardship, please contact Kathy Murphy at
(516) 562 – 9000 for a confidential conversation to learn about our scholarship opportunity.
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HEALTH CARE AT Project COMMON BOND
HEALTH SUPERVISION: We take every precaution to ensure the health of our participants.
Our staff includes qualified medical personnel. Our medical staff will treat participants according
to standard protocol procedures under the direction of licensed physicians. In addition, Project
COMMON BOND continues to have an alliance with the medical staff at the local hospital. In the
unlikely event there should be a medical emergency, parents will be notified as quickly as possible.
Parents will also be notified if a participant needs to be brought to a local doctor or dentist or needs
to stay overnight in an infirmary.
MEDICAL FORMS: The medical form must be completed and signed by a parent/guardian and
your family physician. Please have the form returned by April 30, 2014. No participant will be
allowed to attend unless we have received our medical form.
Please keep in mind that the more we know about the health habits and history of your child, the
better care we can provide. Any and all information pertaining to your child‘s psychological
development (including any counseling) is enormously helpful as we work to maximize your
child‘s experience at PCB. To further help us in this area, we ask you to adhere to the following
guidelines:
1. Abbreviated medical forms from your physician may not be substituted in place of our own
required form. We require all campers to have a completed medical history.
2. Project COMMON BOND makes mandatory the listing by physicians of immunizations
and dates. No participant is exempted from this requirement and all immunization forms
must be included.
3. Please send a second pair of glasses with each camper along with a copy of their
prescription. Children who wear contact lenses should bring adequate cleaning fluid and
an additional pair of lenses.
4. We offer an extensive and varied diet. However, should your children require a special
diet (vegetarian, kosher, etc.) or restriction please let us know. Please indicate any specific
dietary requests on the “Recommendations and Restrictions” portion of the PCB Medical
Form.
5. If your child needs special medication please send written instructions by your physician
for its use. Please give the medication to the chaperone at the departure point. All
medications must be in their original container and must be listed on the medical form. No
child is permitted to keep any medication in his or her room.
6. You and your child’s doctor must sign and submit the Medical Form so that we may
provide treatment for your child in case of an emergency! Failure to sign this form will
mean that your child will be unable to receive any medical treatment by our medical staff
and therefore will not be admitted to PCB.
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CLOTHING LIST AND PACKING
Absolutely Do Not Bring: Game player, computer, expensive music listening device or
other valuables. Tuesday’s Children is not responsible for stolen property.
Basic Clothing: 6 Pairs (any color) Shorts, 10 T-Shirts, 1 Pair Pants,
2 Bathing Suits (girls-1 piece only), 2 Swim Towels.
Culmination Dinner: Girls: nice pants, skirt, dress. No strapless. No denim.
Boys: Dress pants/shorts, dress/golf shirt. No denim.
Under Gear: 8 Pairs Underwear, 2 Pairs Socks, 1 Pair Pajamas (light/cotton)
Bed and Bath: Sheets will be provided. Bring 2 Towels/1 Washcloths.
Shower Organizer – Containing: Toothbrush/Toothpaste/Dental Floss, Comb/Hairbrush,
Soap/Covered Soap Dish (plastic), Shampoo/Conditioner, Deodorant.
Footwear: 1 Pair Sneakers, 1 Pair Shower Flip flops/Sandals
Outerwear: 1 Sweatshirt or Fleece
Optional Articles: Books, Camera & Film (not expensive), Playing cards, Additional Eye Glasses,
Sunscreen, Insect repellent.
Personal Writing Journal: required
Musical Instrument: Optional but encouraged!
***RULES & EXTREMELY IMPORTANT ITEMS***
PROHIBITED ITEMS AND BEHAVIOR:
The use of tobacco products, alcohol, illegal drugs, violence or bullying will absolutely not be
tolerated at Project COMMON BOND. Any participant who does so will be isolated from the
other students for the remainder of the program and in some cases result in early dismissal.
Additionally, it is required that all participants and parents sign the C contract (located in forms
packet). We appreciate your partnership with us to maintain a healthy and safe environment for
everyone.
CELL PHONES & ELECTRONIC DEVICES: Cell phones are permitted at designated times
and places as they take away from the experience for your child and the friends they will make.
Hand held games (like Game Boys) and also individual music listening devices are only allowed to
be used in their room. We strongly recommend not sending expensive cameras or music listening
devices.
PEANUT POLICY: Due to how prevalent life threatening peanut allergies have become, we are
asking participants to please refrain from bringing any products that have peanuts or peanut oil in
them to Project COMMON BOND. Please read your labels carefully before packing snacks for the
bus. If the label says “may be manufactured in a facility where peanuts are processed” - please do
not send that with your child either.
STORING MONEY, PASSPORTS, AND AIRLINE TICKETS AT PCB: Please advise your
child to turn in their money, passports, airline tickets and any other personal items that need to be
kept safe, to the office where it will be stored in a fire-proof safe and be returned to them prior to
departure. WE ARE NOT RESPONSIBLE FOR ANY ITEMS KEPT IN THEIR ROOM.
PARENTS WHEREABOUTS: If you are travelling, please inform us of the dates when you will
not be at your home number along with the numbers where you can be reached.
If you have any questions, do not hesitate to contact:
- Kathy Murphy, Program Director, at kathy@tuesdayschildren.org or (w) 516-562-9000 or
(m) 516-458-7485.
- Aja Minor, Program Manager, at aja@Tuesdayschildren.org or (w) 516-562-9000 or
(o) 212 – 332 – 2976
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Tuesday’s Children
Project COMMON BOND
Medical Form
Participant’s Name: __________________________________
Gender M:____F:____
Birthdate: Month:______Day:_____Year:_________Age:____
Participant’s Email: ___________________________________
Address: ___________________________________________
___________________________________________________
Parent Name: ________________________________________
Cell: ________________________________________________
Work: _______________________________________________
Email: _______________________________________________
Secondary Emergency Contact: __________________________
Phone: _____________________________________________
Medical Insurance name and #:___________________________
**Please attach copy of insurance card.
Doctor’s Name: _______________________________________
Phone Number: _______________________________________
Date of last physical: ___________________________________
Meningococcal: ________________________________________
**Please attach copy of immunization record
Allergies: _____________________________________________
Food/Religious Restrictions: ______________________________________
Current medication: _____________________________________
(If this is a controlled substance please send in original prescription bottle)
Permission to administer Tylenol, Advil and Benadryl:
Parent Signature: ___________________________________________
Health History
Indicate the following by entering an approximate date of last occurrence. Leave blank if not
applicable.
Disease
Date
Disease
Date
______________
Chicken Pox:
______________
Asthma:
Measles:
______________
Hepatitis A:
_______________
German Measles:
______________
Hepatitis B:
______________
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Mumps:
______________
Hepatitis C:
______________
Allergies (Non-Dietary)
□ Hay Fever
□ Ivy Poisonings, etc.
□ Insect Stings
□ Penicillin
□ Other (Specify)
________________________________________________________________________
Dietary Allergies
□ Peanut
□ Shell Fish
□ Citrus
□ Wheat
□ Tree Nuts
□ Flat Fish
□ Mustard
□ Whey
Other Dietary Allergies or Comments. Include description of critical allergic reactions.
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
Dietary Preferences
□ Vegetarian
□ No Dairy
□ No Pork
□ No Poultry
□ Kosher
□ No Red Meat
□ No Seafood
□ No Eggs
Other Specific Dietary Considerations:
_______________________________________________________________________________
_______________________________________________________________________________
_____________________________________________________________________________
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PHYSICIAN’S EXAMINATION
Patient:
______________________, _________________
(Last)
(First)
Address:
_______________________________________________________
City/State/Zip _______________________________________________________
This examination should be performed within 12 months of arrival at camp. Examination for
some other purpose within this period is acceptable.
Height: __________ Weight: ________
Heart: ____________ BP: __________________
Hct/Hgb Test: _____________________
Urinalysis: ______________________________
Eyes: _________ Ears: _____________
Lungs: ________
Nose: ________
Glasses: _________
Hernia: ________
Extremities: ________ Genitalia: ________
Throat: ___________
Abdomen: ________
Skin: ____________ Posture: ___________
Allergy (Please specify):
_________________________________________________________________________
Is this person up to date on all routine childhood immunizations?
□ Yes □ No
Date of last tetanus shot: ____________________
Date of meningococcal meningitis immunization______________
RECOMMENDATIONS AND RESTRICTIONS WHILE AT CAMP
Special Diet: _________________________________________________________________
Current Medications:
___________________________________________________________________________
Swimming/Diving:
_____________________________________________________________________________
Strenuous Activity:
_____________________________________________________________________________
Other:
_______________________________________________________________________________
I have examined the person herein described and have reviewed the health history. It is my
opinion that this person is physically able to engage in camp activities, except as noted above.
_______________________________________________________________________________
(Examining Physician)
(Date)
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CUSTODIAL PARENTS’ AUTHORIZATION
By my signature below, I certify the following:
The Health History is complete and correct to the best of my knowledge. The person named has permission to engage
in all activities except where noted.
I hereby give permission to Tuesday’s Children to provide, seek, and consent to routine health care, administration of
prescribed medications, and emergency treatment for me/my child as may be necessary, including but not limited to xrays, routine tests and treatment, and/or hospitalization. I also give permission for Tuesday’s Children to arrange
related transportation. I agree to the release of any records necessary for treatment, referral, billing or insurance
purposes.
It is my intention that Tuesday’s Children be treated as acting in loco parentis if the person herein named is a minor.
Further, it is my intention that the appropriate representatives of Tuesday’s Children be treated as ‘personal
representatives’ for the purposes of disclosing protected health information pursuant to the privacy regulations
promulgated pursuant to the Health Insurance Portability and Accountability Act of 1996. I hereby agree (pursuant to
45 CFR § 164.510 (b)) to the disclosure to Tuesday’s Children representatives of the protected health information of
the person herein described, as necessary: (i) to provide relevant information to the Tuesday’s Children representatives
related to the person’s ability to participate in activities; and (ii) in the case of minors, to provide relevant information
to the Tuesday’s Children representatives to keep me informed of my child’s health status.
In the event I cannot be reached in an emergency, I hereby give permission to the physician selected by Tuesday’s
Children to secure and administer treatment, including hospitalization, for the person named above. This completed
form may be photocopied for trips off site.
I understand that part of the PCB experience involves activities and group living arrangements and interactions that
may be new to my child, and that they come with certain risks and uncertainties beyond what my child may be used to
dealing with at home. I am aware of these risks, and I am assuming them on behalf of my child. I realize that no
environment is risk-free, and so I have instructed my child on the importance of abiding by the Project Common Bond
rules, and my child and I both agree that he or she is familiar with these rules and will obey them. Not obeying could
result in early dismissal at the parent’s expense.
____________________________________________________
Parent Signature
___________________
Date
Project COMMON BOND 2014
Commitment to Excellence:
Take Care of Yourself, Take Care of Each Other
Take Care of This Experience
You agree that you are willing to:
• Engage each day as a full participant with a positive attitude
• Follow all safety procedures and environmental practices as explained by my
instructors
• Be a reliable team member and act respectfully towards other participants and my
instructors
• Tuesday’s Children adheres to a Zero Tolerance Policy with regards to drugs and
alcohol. Failure to comply will result in being sent home at the family’s expense
• No physical violence (may result in dismissal)
• Refrain from sexual activity and/or socially exclusive behavior
• Do not leave the grounds without permission
• Socialize in common areas only (no dorm rooms)
• Participant and their parent will be responsible for any damage to rooms and
furnishings
• Cell phones should only be used in dorm. No laptops. Computers available on campus
**I understand that failure to follow through on any of the above expectations may
result in being sent home immediately and be responsible for any additional cost
incurred.
Participant Name: ________________________________________
Participant Signature:______________________________________
Parent Signature: _________________________________________
Date: __________________________________________________
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PARTICIPANT WAIVER
The undersigned voluntarily agrees to participate in
Project COMMON BOND 2014 sponsored by Tuesday’s Children.
By my signature, I hereby state that I understand that there are risks involved in
participating in camp activities at Project COMMON BOND and willingly and
voluntarily accept these risks.
By my signature, I hereby surrender any right to seek reimbursement from
Tuesday’s Children and their directors, officers, employees, volunteers, and other
agents for injury sustained and liability incurred during my participation in this
program. By my signature, I warrant that I am not relying on any oral
representation, statements or inducement apart from the statements made on this
form.
By my signature, I hereby consent for my child, if willing, to be interviewed for
multimedia promotion of Project COMMON BOND including photographs, audio,
video and print purposes.
Parent Signature (if child is a minor):
Print Name:
__________
______________________________________________
Participant’s Signature (if over 18 yrs. old): ______________________
Print Name: ___________________________________________________
Date: ________________
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Name:
2014 Elective Possibilities
Program Activities
Throughout the program participants take part in various elective activities. Your fixed elective will be the
elective you participate in every day. You will participate in a different fixed elective each day. Please number
the elective classes from based on your interest level 1-6. Your first choice will determine which Fixed Elective
you are placed in and then your second through sixth choice will determine when you participate in the other flex
electives.
1= Fixed Elective Choice, 2 = First Flex Elective Choice, 3 = Second Flex Elective Choice,
4 = Third Flex Elective Choice, 5 = Fourth Flex Elective Choice, 6= Fifth Flex Elective Choice
Peace.We Choice:
Project COMMON BOND 2013 will be featuring a new spin on an old
program this year. Instead of camp-wide Peace in Action, Heidi Rosbe and
Tommy Dyer will be leading Peace.we, a peacebuilding program offered as an
afternoon elective. After getting to know many of you over past years and
knowing the quality of individuals PCB attracts, Heidi and Tommy are excited
to unleash the potential of the group that signs up for this elective. On day one,
participants will pitch ideas for their own peacebuilding projects and in teams
the group will begin and possibly even complete peace projects during their
week at camp. With the support of PCB's network of amazing people as well as
the support of a select group of mentors and field experts, participants in this
elective will surprise themselves and the community with all that they never
knew they could accomplish in just one week. We look forward to you joining
us in the afternoons and working together to accomplish something great.
In the flex elective, which every PCB participant cycles through during the
week, we'll introduce skills every peacebuilder needs, including leading group
activities. This is your chance to step into the role of a facilitator and try your
hand at leading a group.
Art
Choice:
Art making is both a personal journey and potential bridge to
building empathy and connection among people. The universal
impulse to create visual images is an ancient human need –
crossing all cultures and boundaries and embracing potentialities
and hope. This curriculum encourages curiosity and openness in
the spirit of tapping into individual creativity as a force for
healing, as well as sharing in the group experience as members
of the greater world community.
Fixed
The sessions will include a variety of art projects including
group members creating their own personal 3-dimensional
amulet, paintings, mandalas, collages and a group project,
“The Path to Hope”.
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(Continued from Art elective)
Flex
Participants who come to the art flex elective will have
an opportunity to create group murals based upon
themes brought in the participants, individual paintings
and collages.
Music
Choice:
Music is a language of its own. Through beats and sounds,
participants from various cultures can communicate without the
use of translators. In the music elective, you will explore how
various instruments can be used and you will have an
opportunity to play.
Fixed
The fixed elective will work all week on a performance. All this
practice will culminate in a presentation made at the Project
COMMON BOND talent show on the last day of the
symposium.
Flex
The flex elective will be an opportunity to be exposed to new
kinds of instruments and get a taste of how they can be used.
You will learn a little about the history of the instruments then
have a brief opportunity to use the instruments
Drama
Choice:
Fixed
In this elective we will play with purpose. The group will focus
on creating dialogue and building community through a variety
of action methods. Presented within a framework of ethics and
cultural competency, participants will play within a variety of
storytelling and theatrical structures. We will prepare for a
culminating presentation on the final night of the program using
spoken word and embodied expression. As future facilitators of
change in the world, participants will essentially find a way to
articulate not only where we stand both together and
individually but also the change to which we aspire.
Flex
We will play using dramatic improvisation, poetry/text, and
storytelling. We will also play through improvised
performance. Through drama, participants will examine the
necessity of play in their lives—the creative spirit, the
adventurer, our connection to each other, and laughter, too. The
drama elective will offer participants the opportunity to explore
creative self-expression through play and community building
activities.
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Movement Choice:
Dance and movement share the philosophy that the mind,
emotion and body are integrated. Dance and movement activities
support an individual along the path of personal wellness and
self-discovery. Participants will learn about the nonverbal
expressiveness of their actions; how their personal movement
style influences their every day functioning both emotionally and
physically; and the continuum created by the physical
embodiment of emotional stress observable in their posture,
breath and muscular tension patterns.
Fixed Elective
The fixed elective will focus on exploring various forms of
movement and how they can be incorporated into various forms
of dance. As a group we will then take what we have learned
about various forms of movement and incorporate them into a
final piece for the talent show.
Flex Elective
The flex elective will provide a snapshot of the fixed elective. It
is an opportunity to explore something new and gain perspective
on our bodies, something we know well, but reflect on rarely.
Sports
Choice:
Communication and teamwork are the two core values that will
be stressed in the sports elective. The sports elective will
provide a space to work on teambuilding skills in an active and
energetic environment.
*We encourage all levels of musical talent! If you play an instrument, what instrument do you play?
If possible, please bring it to the program.
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