Summer Camp Registration

Campers Name

First Name Last Name

Birthday Grade

D/M/Y Going into September 2022

Allergies

Food, Environmental, Medical

Medications

Addition Information

Medicare #

Medical Coverage

Doctors Name Doctors Number

Guardian 1

Name

First Name Last Name

Home Number

Area Code Phone Number

Cell Number

Area Code Phone Number

Work Number

Area Code Phone Number

Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code

Email

example@example.com

Guardian 2

Name

First Name Last Name

Home Number

Area Code Phone Number

Cell Number

Area Code Phone Number

Work Number

Area Code Phone Number

Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code

Email

example@example.com

Additional Emergency Contact

First Name Last Name

Home Number

Area Code Phone Number

Cell Number

Area Code Phone Number

Camps - K- grade 5

Crafting Kiddos July 11-15 $35 Great Bake-Off July 18-22 $35 Mad Science Aug 8-12 $35 Pop-Up Shop Aug 15-19 $35

Councillor In Training - Middle School

Crafting Kiddos July 11-15 $35 Great Bake-Off July 18-22 $35 Mad Science Aug 8-12 $35 Pop-Up Shop Aug 15-19 $35

Total (All Camps)

Dollar Value

Payment

E-transfer in the prefered method of payment. Details will be sent after registration if processed.

*Snacks are included but if your child has severe allergies and you would prefer to send snacks for them, feel free.

The Fine Print

Payment and Refund Policy

·All payments are due before the start date of camp.

·There is no refund once camp date starts.

·There are no fee adjustments if a guest arrives late or leaves early.

·Morning Gate Church reserves the right to cancel any program due to a lack of participants.

Inappropriate Behaviour

MG Camps reserve the right to send campers home for inappropriate or dangerous behaviour (as determined by the Director or deligate) without refund. The safety and security of all our campers is always of the highest priority.

Medication Info

Please send a list of prescribed medications/treatments. Campers are not to leave the campgrounds except when previously arranged by guardians. The dosage of medications given to campers will be as directed by the package unless otherwise indicated by parent/guardian.

Waiver and Condition of Enrollment

1. The Camp Director reserves the right to dismiss a camper who in his/her opinion is a hazard to the safety and rights of others, or who appears to have rejected the reasonable controls of the camp. The parent/guardian certifies that the camper is amenable to necessary guidance. Failure to disclose behavior with registration could result in dismissal. By making us aware of specifics, we are able to alter and adjust our response as necessary for each child with better results.

2. The parents/guardians submitting this form are those having legal custody over the child. Conditions of custody, if applicable, will be fully communicated to the camp. This is to ensure drop off and pick up protocol are followed.

3. I, the parent or guardian of the named participant on this form, release Morning Gate Church, it’s summer camps, trustees, directors, staff and agents from any loss, personal injury, accident, misfortune or damage to the named participant on this form or his/her property, with the understanding that reasonable precautions shall be taken to ensure the health and safety of the named camper on this form.

4. Each camper must be covered by NB Medicare or equivalent medical insurance. The signature or digital signature of the parent/guardian on the application shall give the Camp Director the right to arrange for any special services or other requirements necessary for the best interest of the camper and shall give the Camp Director the right to approve and obtain medical attention necessary for the camper’s welfare and good health including ordering injection, anaesthesia or surgery. In such a situation the camp will attempt to notify the parents as soon as possible. The parents/guardians are responsible for any additional expense that may result from such services.

5. I agree to permit reasonable use of photos and videos or other pictures of applicant camper in promoting the camp or camp activities and programs.

6. I agree that the information collected will only be used by MG Summer Camps for the specific purpose of providing my child with a memorable camp experience. In order to do so, MG Summer Camps may need to share sensitive information with its staff, and appropriate medical personnel.

7. I have read this entire waiver and I accept the waivers, conditions and policies.

Release

I agree to the terms and conditions of enrollment and have the legal authority to agree to them on behalf of the camper.

Signature

Clear

Date Signed