Asthma Summer Camp Superstuff 2018 Registration
To register for the 2018 Asthma Summer Camp Superstuff, follow five simple steps.
Step 1: Obtain and complete the 2018 Asthma Camp Super Stuff Application Form.
Option 1: Download and print Asthma Camp Superstuff Application Form (Available in English and Español)
Option 2: Pick up the Asthma Camp Superstuff Application Form at our office located in 1469 Park Ave. San Jose CA, 95126.
Option 2: Pick up the Asthma Camp Superstuff Application Form at our office located in 1469 Park Ave. San Jose CA, 95126.
Step 2: Obtain and complete the 2018 Asthma Camp Superstuff Physician's Form.
Option 1: Download and print the 2018 Asthma Camp Superstuff Physician's Form
Option 2: Pick up the 2018 Asthma Camp Superstuff Physician's Form at our office located in 1469 Park Ave. San Jose CA, 95126.
Option 2: Pick up the 2018 Asthma Camp Superstuff Physician's Form at our office located in 1469 Park Ave. San Jose CA, 95126.
Step 3: Obtain a copy of your child's insurance card
Step 4: Complete Payment (If required)
NOTE: There is NO cost for children covered by the Santa Clara Family Health Plan or Valley Health Plan
Option 1: Complete payment over the phone by calling (408) 998-5865, Ext. 109 and ask for Shaaban Ghaus.
Option 2: Complete payment in person at our office located in 1469 Park Ave. San Jose, CA 95126.
Option 3: Send payment by mail to Breathe California, 1469 Park Avenue, San Jose, CA 95126.
Registration Deadlines
$150 Now - July 1st
$170 After July 1st
*If you need financial assistance, apply for the 2018 Camp Scholarship.
Option 1: Download, print, and complete the 2018 Camp Scholarship Form.
Option 2: Pick up a 2018 Camp Scholarship Form from our office at 1469 Park Ave. San Jose, CA 95126
Camp fee/scholarship application must be received to reserve your spot.
Option 1: Complete payment over the phone by calling (408) 998-5865, Ext. 109 and ask for Shaaban Ghaus.
Option 2: Complete payment in person at our office located in 1469 Park Ave. San Jose, CA 95126.
Option 3: Send payment by mail to Breathe California, 1469 Park Avenue, San Jose, CA 95126.
Registration Deadlines
$150 Now - July 1st
$170 After July 1st
*If you need financial assistance, apply for the 2018 Camp Scholarship.
Option 1: Download, print, and complete the 2018 Camp Scholarship Form.
Option 2: Pick up a 2018 Camp Scholarship Form from our office at 1469 Park Ave. San Jose, CA 95126
Camp fee/scholarship application must be received to reserve your spot.
Step 5: Have all the documents? Send them in!
Once you have completed these four steps:
Send us your documents either by:
Option 1: Fax at (408) 998-0578
Option 2: Drop off at our office located in 1469 Park Ave. San Jose, CA 95126
Option 3: Send by mail to Breathe California, 1469 Park Ave., San Jose, CA 95126
Once all forms are completed, processed for eligibility, and fees are paid, you will be notified of your acceptance and confirmation information will be mailed or emailed to you. REGISTRATION IS ACCEPTED ON A FIRST-COME, FIRST-SERVED BASIS, and your application will be considered only after these four steps have been completed.
- Complete 2018 Asthma Camp Superstuff Application Form
- Complete 2018 Asthma Camp Superstuff Physician's Form
- Make a copy fo your child's insurance card
- Make payment or fill out a scholarship application (for non-Santa Clara Family Health Plan and non-Valley Health Plan members)
Send us your documents either by:
Option 1: Fax at (408) 998-0578
Option 2: Drop off at our office located in 1469 Park Ave. San Jose, CA 95126
Option 3: Send by mail to Breathe California, 1469 Park Ave., San Jose, CA 95126
Once all forms are completed, processed for eligibility, and fees are paid, you will be notified of your acceptance and confirmation information will be mailed or emailed to you. REGISTRATION IS ACCEPTED ON A FIRST-COME, FIRST-SERVED BASIS, and your application will be considered only after these four steps have been completed.
