Chava Farms Camp Registration Package

Chava Farms Camp Registration Package
It is recomended that you save your progress as you go. To do this, click the 'save' button at the bottom of the page. You can also save, leave and return to the form later.
It is recomended that you save your progress as you go. To do this, click the 'save' button at the bottom of the page. You can also save, leave and return to the form later. All Registration forms need to be accompanied by a deposit.
Please Note: Overnight camp runs Monday - Fridays. Campers return home for Shabbos and Sundays and return back to camp on Monday
Session Dates and Rates*

Session 1D GIRLS Day: June 30 - July 11. $1400 + $430 (busing $300 & hot lunches $130). Total: $1830Session 1S GIRLS Overnight: June 30 - July 11. $2800 + $100 (busing). Total: $2900Session 2D GIRLS Day: July 14 - July 25. $1400 + $430 (busing $300 & hot lunches $130). Total: $1830Session 2S GIRLS Overnight: July 14 - July 25. $2800 + $100 (busing). Total: $2900Session 3D Girls Day: June 30 - July 25. $2800 + $860 (busing $600 & hot lunches$260). Total $3660Session 3S Girls Overnight: June 30 - July 25. $5600 + $200 (busing). Total: $5800Session 4D BOYS Day Camp: July 28 - August 1. $700 + $TBA Total: $TBASession 4E BOYS Day Camp: Aug. 4 - Aug 8. $700 + $TBA Total: $TBASession 4F BOYS Day Camp: Aug. 11 - Aug. 15 $700 + $TBA Total: $TBA

Camper's Name*

First NameLast Name
Gender

MaleFemale
School Attending*
Grade*
Age at start of camp*
Date of Birth*

MonthDayYear
Date
Parent/Guardian Contact information

Primary Contact
Name *

First NameLast Name
Relationship to camper*
Phone #*
Please enter a valid phone number.
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*
example@example.com
Secondary Contact
Name*

First NameLast Name
Relationship to camper*
Phone #*
Please enter a valid phone number.
Address:*

Same as primary contactDifferent
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*
example@example.com

Other Information & Preferences

Please note that we cannot guarantee all requests however we will try our best.
Type of accommodation preferred*

Outdoor campingIndoor accommodationEither
Please specify your child's level of swimming competency. Include Red Cross level just passed or working on. (Campers who do not have their minimum red cross level 5 and do not demonstrate strong swimming capabilities, will be required to wear a life jacket.)*
Bunk Mate Request

Camp Woodlands General Activity Waiver

This agreement must be read in full, dated and signed by the camper or the camper's parent/guardian if the camper is under 18 years of age.
Warning: This agreement will affect your legal rights. Please read it carefully.
To: Camp Woodlands Inc.
hereinafter referred to as the operator.

DEFINITION
In this agreement the term "Activities" shall include all activities and the associated instruction in anyway related to the activities that Camp Woodlands Inc, offers at Camp Woodlands Overnight Summer Camp or Day Camp including: horseback riding instruction, horseback trail riding, horsemanship skills, swimming, kayaking, canoeing, paddle boat, paddle board, dance, art, camp craft, pioneering, gardening, hiking, outback camping, low rope course games and bivyvle riding, herinafter referred to as the "Activities".
Please check 'I agree' next to each of the following statements to confirm that you have read and fully understood each point.
ACKNOWLEDGEMENT - I acknowledge that I have been advised to wear a helmet and appropriate footwear during all "Activities" related to Horses and Horse back riding. I acknowledge that I have been advised to wear a life jacket related to all "Activities" related to the lake front. I am aware that physical exertion is required by the "Activities" offered at Camp Woodlands and the forces exerted on the body can activate or aggravate pre-existing physical injuries, conditions, symptoms or congenital defects. I have been advised to seek medical advice if I know or suspect that my physical condition may be incompatible with the "Activities". I acknowledge that I am not nor will I be under the influence of drugs or alcohol while participating in the activities.

I agree
ASSUMPTION OF RISKS - I am aware that the "Activities" offered by Camp Woodlands may involve many risks, dangers and hazards, including but not limited to: accidents which occur during; encounters with domestic animals; high winds; tripping or sliding on trails. I am also aware that fishing, hiking, backpacking, camping and back country travel involve many risks, dangers and hazards, including but not limited to: steep slopes in their natural state that may contain obstacles or becoming lost or separated from the guide or party; rock slides; change in weather conditions; negligence of other participants. i am also aware that there is a risk of negligence on the part of the operators including the failure by the operators and their staff to safeguard or protect me from the risks, dangers and hazards of the activities. I freely accept and fully assume all risks, dangers and hazards associated with the activities and the possibility of personal injury, death, property damage or loss resulting therefrom.

I agree
RELEASE OF LIABILITY, WAIVER OF CLAIMS AND INDEMNITY AGREEMENT - I am aware that the "Activities" offered by Camp Woodlands may involve many risks, dangers and hazards, including but not limited to: accidents which occur during; encounters with domestic animals; high winds; tripping or sliding on trails. I am also aware that fishing, hiking, backpacking, camping and back country travel involve many risks, dangers and hazards, including but not limited to: steep slopes in their natural state that may contain obstacles or becoming lost or separated from the guide or party; rock slides; change in weather conditions; negligence of other participants. i am also aware that there is a risk of negligence on the part of the operators including the failure by the operators and their staff to safeguard or protect me from the risks, dangers and hazards of the activities. I freely accept and fully assume all risks, dangers and hazards associated with the activities and the possibility of personal injury, death, property damage or loss resulting therefrom.

I agree
In consideration of THE OPERATORS agreeing to my participation in the "Activities" offered by Camp Woodlands Inc at Camp Woodlands and permitting my use of its equipment and outdoor adventure facilities (hereinafter referred to as "the facilities"), and for other good and valuable consideration, the receipt and sufficiency of which acknowleged, I hereby agree as follows:
1. To waive any and all claims that I have or may in the future have against the operators and the province, and their directors, officers, employees, agents, guides, instructors, independent contractors, subcontractors and representatives (all of whom are hereinafter referred to as the "Releasees") and to release the releasees from any and all liability for any loss, damage, expense or injury including death that I may suffer, or that my next of kin may suffer as a result of my participation in the "Activities", due to any cause whatsoever, including negligence, breach of contract, or breach of any statutory or other duty of care, including any duty of care owed under the occupiers' liability act, on the part of the releasees, and further including the failure on the part of the releasees to safeguard or protect me from the risks, dangers, and hazards of the "Activities".

I agree
2. To hold harmless and indemnify the releasees from any and all liability for any property damage or personal injury to any third party resulting from my participation in the "Activities" offered at Camp Woodlands by Camp Woodlands Inc.

I agree
3.That this Agreement shall be effective and binding upon my heirs, next of kin, executors, administrators, assigns and representatives, in the event of my death.

I agree
4. That this Agreement shall be governed by and interpreted in accordance with the laws of the Province of Ontario; and

I agree
5. That any litigation involving the parties to this Agreement shall be brought within the province of Ontario.

I agree
6.PHOTO RELEASE - I consent to photographs taken of me during my participation in the "Activities", and to publication of the photographs by the Operators for advertising, promotional and marketing purposes.

I agree
In entering into this Agreeement I am not relying on any oral or written representations or statements made by the Releasees with respect to the safety of the "Activities", other than what is set forth in this Agreement.

I CONFIRM THAT I HAVE READ AND UNDERSTOOD THIS AGREEMENT PRIOR TO E-SIGNING IT AND I AM AWARE THAT BY SIGNING THIS AGREEMENT I AM WAIVING CERTAIN LEGAL RIGHTS WHICH I OR MY HEIRS, EXECUTORS, ADMINISTRATORS, ASSIGNS AND REPRESENTATIVES MAY HAVE AGAINST THE RELEASES.
Camper's Name*

First NameLast Name
Name of Legal Parent/Guardian*
Date*

MonthDayYear
Date
By signing your name electronically, you are agreeing that your electronic signature here is the legal equivalent of your manual signature on this form.
E-Signature*

Clear

Woodlands Riding Program Equine Liability Waiver

For participants under the age of the majority in the Province or Territory in which the Equine Activities are provided by the host. The parent/guardian must read and understand this waiver prior to the infant participating in Equine Activities.
Rider's Name*

First NameLast Name
Warning: This agreement will affect your legal rights. Please read it carefully.

The following waiver of all claims, release from all liability, assumption of all risks, agreement not to sue and other terms of this agreement are entered into by me on behalf of the Infant Participant named below with and for the benefit of Camp Woodlands Inc, its directors, officers, employees, volunteers, business operators, agents, and site property owners or lessees (Sara Tamar Ackermann, director of Camp Woodlands as well as all employees of Camp Woodlands, collectively called the “Host”). Without limiting the generality of the foregoing, “Equine Activities” includes but is not limited to trail rides, pack trips or riding instruction provided by the "Host" to the Infant Participant.

Please check 'I agree' next to each of the following statements to confirm that you have read and fully understood each point.
1. I am the Parent/Guardian of the Infant Participant and am executing this waiver on behalf of the Infant Participant in my capacity as Parent/Guardian and with the intent that this waiver be binding on myself and the Infant Participant for all legal purposes.*

I agree
2. I am aware that there are inherent dangers, hazards and risks (“Risks”) associated with "Equine Activities" and injuries resulting from these "Risks" are a common occurrence. I am aware that the "Risks" of "Equine Activities" mean those dangerous conditions which are an integral part of "Equine Activities", including but not limited to:(a) the propensity of any equine to behave in ways that may result in injury , harm or death to persons on or around them and to potentially collide with, bite or kick other animals, people or objects;(b) the unpredictability of an equine’s reaction to such things as sounds, sudden movement, tremors, vibrations, unfamiliar objects, persons or other animals and hazards such as subsurface objects; and(c) the potential for other participants to behave in a negligent manner that may contribute to injury to themselves or others, including failing to act within their abilities to maintain control over an equine.*

I agree
3. I freely accept and fully assume all responsibility for all "Risks" and possibilities of any and all personal injury, death, property damage or loss resulting from the Infant Participant’s participation in "Equine Activities".*

I agree
4. I agree that although the "Host" has taken steps to reduce the "Risks" and increase the safety of the "Equine Activities", it is not possible for the "Host" to make the "Equine Activities" completely safe. I accept these "Risks" and agree to the terms of this waiver on behalf of the Infant Participant, even if the "Host" is found to be negligent or in breach of any duty of care or any obligation to myself or the Infant Participant in the Infant’s participation in "Equine Activities".*

I agree
5. In addition to consideration given to the "Host" for the Infant Participant’s participation in "Equine Activities", I and my heirs, next of kin, executors, administrators and assigns, as well as the Infant Participant and his/her heirs, next of kin, executors, administrators and assigns (collectively our “Legal Representatives”) agree:(a) to waive all claims that the Infant Participant has or may have in the future against the "Host";(b) to release and forever discharge the "Host" from all liability for personal injury, death, property damage, or loss that I, the Infant Participant, or our "Legal Representatives" might suffer as a result of the Infant Participant’s participation in "Equine Activities" due to any cause, including but not limited to negligence (failure to use such care as a reasonably prudent and careful person would use under similar circumstances), breach of any duty imposed by law, breach of contract or mistake or error in judgment of the "Host"; and (c) to be liable for and to hold harmless and indemnify the "Host" from all actions, proceedings, claims, damages, costs demands, including court costs and costs on a solicitor and own client basis, and liabilities of whatsoever nature or kind arising out of or in any way connected with the Infant's participation in "Equine Activities".*

I agree
6. I agree that this waiver and all terms contained herein are governed exclusively and in all respects by the laws of the Province of Ontario, Canada in which the "Equine Activities" are provided by the "Host". I hereby irrevocably submit to the exclusive jurisdiction of the courts of that Province and I agree that no other court can exercise jurisdiction over the terms and claims referred to herein. Any litigation to enforce this waiver will be instituted in the Province or Territory of Canada in which the "Equine Activities" are provided by the "Host".*

I agree
7. I confirm that I have had sufficient time to read and understand this waiver in its entirety. I understand that this agreement represents the entire agreement between the "Host", myself as Parent/Guardian, and the Infant Participant, and it is binding on myself, the Infant Participant and our "Legal Representatives".*

I agree
By signing my name electronically I agree that my electronic signature here is the equivelant to my manual signature.
Name of Legal Parent/Guardian*
Date*

MonthDayYear
Date
E-Signature*

Clear

Facility Waiver for Day Camp
ASSUMPTION OF RISKS, RELEASE OF LIABILITY, WAIVER OF CLAIMS, AND INDEMNITY AGREEMENT

BY SIGNING THIS DOCUMENT YOU WILL WAIVE CERTAIN LEGAL RIGHTS INCLUDING THE RIGHT TO SUE. PLEASE READ CAREFULLY.
TO:
Bashir Zeina & Hassan Zeina (referred to in this agreement as the "Provider")

AND TO:
ALL PROPERTY OWNERS (PRIVATE, FEDERAL, PROVINCIAL, REGIONAL AND MUNICIPAL)

On my behalf, and on behalf of any minor children participating in these activities, for whom I am legally responsible, I agree to the following:
ASSUMPTION OF RISKS
I am aware and understand that activities involving these horses involve many risks, dangers and hazards, including, but not limited to the following:

1. Horses, which are powerful and potentially dangerous animals, may change their behavior at any time and may, without warning, jump, run wildly, buck, kick, bite, or step on people or things;

2. Horses may collide with other horses or objects or trip, stumble or fall even if being led, ridden or driven, or attended to;

3. Negligence (which means, in general terms, a failure to exercise ordinary or proper care) of other riders or drivers my or my child's own failure to ride safely, within my or my child's ability or within designated areas and trails;

4. Equipment may fail;

5. Weather conditions can change and can sometimes be dangerous;

6. The nature of the terrain can change and has certain risks associated with it including, but not limited to, exposed natural objects, trees, streams and creeks;

7. The activities can sometimes be in remote areas and injuries or illness may occur and it may be a considerable distance to doctors, hospitals, or any other type of assistance; and

8. Negligence on the part of A PROPERTY OWNER AND/OR THE PROVIDER OR THEIR STAFF. I am also aware that the risks, dangers and hazards referred to above exist throughout the trail, stable, practice and other areas and many are unmarked. I understand and acknowledge that no amount of caution, experience or instruction can eliminate all of the risks involved and I freely accept and fully assume all such risks, dangers and hazards and the possibility of personal injury, death, property damage and damages or loss resulting there from.
INITIALS*
RELEASE OF LIABILITY, WAIVER OF CLAIMS AND INDEMNITY AGREEMENT
In consideration of the Provider providing me or my child with their horse or sleigh riding or carriage driving and other services and permitting my or my child's user of their equipment, and other facilities and the Property Owners providing me or my child with the use of their property (hereinafter collectively referred to as "the Services"), I hereby agree as follows:

1. TO WAIVE ANY AND ALL CLAIMS that I or my child have or may in the future have against a Property Owner or the Provider, and their directors, officers, employees, agents, representatives, and volunteers (all of whom are hereinafter collectively referred to as "THE RELEASEES") and TO RELEASE THE RELEASEES from any and all liability for any loss, damage, injury or expense that I or my child may suffer, or that my or my child's, next of kin may suffer as a result of my or my child's use of the services or due to any cause whatsoever. INCLUDING

NEGLIGENCE, BREACH OF CONTRACT, OR BREACH OF ANY STATUTORY OR OTHER DUTY OF CARE INCLUDING ANY DUTY OF CARE OWNED UNDER THE "OCCUPIERS LIABILITY ACT" ON THE PART OF THE RELEASEES;

2. TO HOLD HARMLESS AND INDEMNIFY THE RELEASEES from any and all liability for any damage to the property of or personal injury to any third party resulting from my or my child's use of the services;

3. This Agreement shall be effective and binding upon my or my child's heirs, next of kin, executors, administrators, assigns and representatives in the event of my or my child's death or incapacity;

4. This agreement shall be governed by and interpreted in accordance with the laws of the province of Ontario; and

5. Any litigation involving the parties this Agreement shall be brought within the Province of Ontario.
INITIALS*
PROTECTIVE HEAD GEAR & RIDING BOOTS
1. Proper riding footwear is required by all persons, regardless of age, participating in any horse related activities.

2. ALL MINORS (Horse back riders under 18 years of age) are required to wear protective head gear in the form of a high impact helmet and proper footwear.

3. IT IS HIGHLY RECOMMENDED THAT ALL HORSE BACK RIDERS OF ANY AGE WEAR A HIGH IMPACT HELMET.
4. I (we) decline to wear helmet(s)
INITIALS
5. I (we) decline to wear riding boots
INITIALS
In entering into this Agreement, I am not relying upon any oral or written representations or statements made by the Releasees other that what is set forth in this Agreement.

I HAVE READ AND UNDERSTAND THIS AGREEMENT AND I AM AWARE THAT BY SIGNING THIS AGREEMENT, FROM THIS DAY FORWARD, I AM WAIVING CERTAIN LEGAL RIGHTS WHICH I, MY CHILD, MY HEIRS, NEXT OF KIN, EXECUTORS, ADMINISTRATORS, ASSIGNS AND/OR REPRESENTATIVES MAY HAVE AGAINST THE RELEASEES.
Signature*

Clear
Date*

MonthDayYear
Date
Name*

First NameLast Name
Date of birth*

MonthDayYear
Date
Witness*
Date

MonthDayYear
Date
Does the participant have any physical or cognitive disabilities that could affect their ability to participate in day-to-day activities and programs? Please list and describe below or answer N/A
Type a question
THIS AGREEMENT MUST BE COMPLETED IN FULL, SIGNED, DATED, AND WITNESSED BEFORE ANY ACTIVITY WITH HORSES MAY BE UNDERTAKEN
Should be Empty:

Chava Farms Camp Registration Package

Parent/Guardian Contact information

Other Information & Preferences

Medical Form

Camper information

Emergency Contact Information

Physician's Information

Allergy Information

Medications

Medical History

Emotional, Social & Mental Health History

Medical Terms & Conditions

Payment Terms & Conditions

Camp Woodlands General Activity Waiver

Woodlands Riding Program Equine Liability Waiver

Facility Waiver for Day Camp

ASSUMPTION OF RISKS, RELEASE OF LIABILITY, WAIVER OF CLAIMS, AND INDEMNITY AGREEMENT

ASSUMPTION OF RISKS

RELEASE OF LIABILITY, WAIVER OF CLAIMS AND INDEMNITY AGREEMENT

PROTECTIVE HEAD GEAR & RIDING BOOTS