Intro to Adventure Summer Camp Application 2023

Intro to Adventure Summer Camp Application 2023

Please fill out all sections below. Confidentiality: Any confidential information requested is for our records. The answers you provide will be kept confidential. Your cooperation in providing this information is both appreciated and necessary
READ FIRST

*These camps are for youth ages 10 - 18. Youth must be at least 10 years old to participate!

**Please scroll down to Inventory section at bottom of application before starting to ensure week of choice is available! If no weeks are available, camps are sold out. If a week shows up as available but you are unable to submit, another applicant may have selected the last spot and submitted first, unfortunatly.

***If you are looking for Mountain Biking Specific camps, there is a different application for them. You can find it here.
Dear parent or legal guardian,

Elevation Outdoors is running a summer day camp program called “Intro to Adventure” this summer for youth ages 10-18 in the Okanagan. The “Intro to Adventure” camp will provide participants with an introduction to a variety of activities including, but not limited to, mountain biking, indoor rock climbing, hiking, and adventure parks. The camps will run on a Monday to Friday schedule each week. The program will utilize local operators that specialize in each activity to ensure the instruction is being provided by experienced staff who will provide the best learning environment possible while maximizing the experience.

The camps start each day at 9:00am and run until 4:00pm, when your child will be ready for pick up.

Pick up and drop off will be at:
Martin Avenue Community Centre
9:00am drop off and 4:00pm pick up.
1434 Graham St, Kelowna, BC V1Y 3A8

Camp organizer can be reached at 250-870-9094

Lunch and snacks are the responsibility of the camper to bring with them, food is not provided. As the campers will be very active please ensure you pack enough lunch/snacks and water for a full day of activity. We are requesting that you fill out the forms attached stating that you have read and are aware of the inherent risks of this activity before your child is permitted to
participate in the program.

By paying for a spot for your child in our Intro to Adventure program it helps us create scholarship seats in our other programs for youth in the community that would not otherwise have an opportunity to share in these types of experiences.
Application Form
Full Name of Camper*

First NameLast Name
Preferred Name of Camper*
Child's Pronouns*
Best Phone Number to reach you at*

Area CodePhone Number
Age of camper at date of camp*
How did you hear about us?
Place of Residence as of July 1th, 2023*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Do you self-identify as indigenous? - All information will be kept confidential in accordance with federal law and does not affect your eligibility for our programs, we collect this information to provide participant demographics to our funders.

YesNoPrefer not to answer
If you answered 'yes' to the previous question, please select from list below:
Are you a first time mountain biker?*
If you responded 'No' to the previous question, please tell us how many days' experience you have and how long ago.
Do you own a bike with single or dual suspension? (Not required, but we would like to know if you are using your own bike for the camps. It must have at minimum front suspension and disc brakes. Our team will look it over on Day 1 to determine if it is suitable for the program and we will provide a bike if it is not.)*
Please enter youth's height, weight, shirt and shoe size (for supply and rental purposes):
Intro to Adventure Behaviour Agreement

Please read all the information below and sign where it is requested.
PARENT/GUARDIAN CONSENT

I give consent for my child to take part in the “Intro to Adventure” Program. I understand that my Participant will be in the care of the Elevation Staff and “Intro to Adventure” Instructors at all times until picked up by Parent/Guardian.

I understand that if my child’s behavior is not appropriate I will be asked to pick up my Participant or they will be sent home at my expense. I understand that if my child does not abive by the Covid-19 protocols they will be sent home at my expense.

(Please review Participant Expectations below).
Parent/Guardian Signature*

Clear
PARTICIPANT BEHAVIOUR AGREEMENT

I understand that when I am participating in the “Intro to Adventure” Program I am expected to follow the expectations as stated below. I also understand that “Intro to Adventure” Instructors are responsible for my Safety and well-being.

Expectations
1. I will listen and take direction from all Instructors/facilitators/staff.
2. I will at all times let the Instructors know where I am.
3. I understand that if my behavior is not appropriate, I will be asked to leave and my Parent/Guardian will be contacted to pick me up.
4. I will abide by all Covid-19 protocols.
Participant Signature*

Clear
Intro to Adventure Permission Form

Please read all the information below and sign where it is requested.
Description of Programs and Inherent Risks

Your child and/or children are about to take part in a one of a kind outdoor experience. Elevation Outdoors strives to provide the safest and most exciting outdoor experience possible. Through Staff training and well-developed policies and procedures we strive to minimize any risks to Participants in the program. The safety of our Participants is always the first priority with all of our activities. With this in mind we want Parents to understand the following risks that are inherent in our outdoor program.

Inclement weather is to be expected including, but not limited to, heat, cold, wind, rain, snow and violent storms. Sudden unexpected changes to the weather are part of an outdoor experience and should be expected. Participants must have
proper adequate equipment and clothing to minimize the risk of injury due to exposure and to maximize the chance for a good adventure. The inherent risks, hazards and dangers include but are not limited to the following: allergies (bees, wasps, hay, etc.), minor injuries (scratches, cuts, etc.), major injuries (sprains, strains, breaks, lacerations, anaphylactic shock, etc.) and head, neck and back injuries, death, collision with other riders, vehicles, trees, tree stumps, tree wells or other obsjets; fences and other man-made structures; mehanical failure of equipment; rpid and uncontrolled acceleration on hills and inclines; changing weather conditions, unsafe terrain including steep or slippery sections, cliffs, rocks, holes, or crevices; extreme variation in cycling terrain; encounters with domestic and non-domestic animals; falling or being thrown off the mountain bike; negligence on the part of Elevation Outdoors – including the failure to protect the participant from the risk, dangers and hazards of mountain biking or other activities or to predict the whether the terrain is safe for mountain biking; or negligence of other riders.

In an effort to make activities as safe as possible, it is vital that participants follow all instructions concerning the safety and rules of each activity. Additional risks could develop if Participant does not carefully follow instructions and rules of each of the activities.

I hereby, acknowledge that I am aware of the risks involved in and arising out of participation in activities offered. I therefore waive, release, forgo against Elevation Outdoors, its members, organizers, sponsors, officers, supervisors, directors, employees, agents, workmen and any person(s) participating or assisting in the carrying out of the activities of the organization. I hereby agree to hold and save harmless Elevation Outdoors for any claims, demands, suits, actions
and/or causes of actions resulting form, or resulting out of, or occasioned by me or my child’s participation in any or all of the activities of Elevation Outdoors.

I have read the attached letter and vendor waivers and understand the inherent risks in the activities of climbing, biking, hiking and adventure park use as well as the risks of participating in the “Intro to Adventure program”. I give my child
permission to participate in this program with this in mind.
Parent/Guardians Full Name*

First NameLast Name
Please Read and Sign - Parent/Guardians Signature*

I have read the above letter and understand the inherent risks of the activities included, as well as the risks of participating in the program. I give my child permission to participate with this in mind. Clear
Participants Full Name*

First NameLast Name
Please Read and Sign - Participants Signature*

I have read the above letter and understand the inherent risks of the activities, as well as the risks of participating in the program. I still want to participate with this in mind. Clear
Photo and Video Release - Parent/Guardian Signature

Elevation Outdoors has permission to use my or my child’s photograph/video/audio recordings to promote the organization. I understand that the images may be used in various formats not limited to print publications, online publications, presentations, websites,and social media. Clear
Email - Please enter your email address so we can send you any additional information or waivers required.*
example@example.com
Please indicate if you would like to receive electronic communication from Elevation Outdoors regarding future program opportunities.*

YesNo
Input Todays Date*

MonthDayYear
Date
Participants Medical Form

Please fill out all the requested information
Participants Name*

First NameLast Name
Participants Date of Birth*

MonthDayYear
Date
Participants BC Care Card Number*
Please provide the correct care card number
Name of Family Doctor*
Phone Number of Family Doctor*
Parent/Guardians Name*

First NameLast Name
Parent/Guardian Address as of July 1st, 2023.*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent/Guardians Phone number - Provide preferred contact number*

Area CodePhone Number
Parent/Guardians Alternate Phone number - provide a second number to be reached at (Work, Home, Cell)

Area CodePhone Number
Emergency Contact - Provide who we should call in case we cannot reach you in case of emergencies.*

First NameLast Name
Emergency Contact Phone Number - Please provide the number of the person listed above.*

Area CodePhone Number
What is the Emergency Contact's relationship with the camper?*
Medical History
Has you child ever suffered from Asthma?*
If Yes, please provide if they have medication and what it is/usage.
Does your child suffer from any allergies?*
If yes please list what they are and any medications they take, if it is anaphylactic and if they have an EpiPen.
Does your child suffer from any of the following?*
Please select any/all that apply. Hold Cntrl or Command to select multiple entries.
If you selected any of the above options, please provide more information about them below.
Please let us know what the issue is/was, any medications they are on, and best practices for managing it.
When was the participants last Tetanus shot?*
Answer as accurately as possible. If not within the last 10 years, participant may receive a tetanus injection by a medical officer if they receive a tetanus prone wound.
Is your child on any ongoing medications?*
Please provide details of medications, dosage, and frequency taken.
If you answered yes to the above question, do you give permission to your child to self administer these medications?
If no please explain.
Please select any of the following non-prescription medications you give permission for your child to receive if needed.*
Hold Cntrl or Command to select multiple options.
Is there anything about your child's situation that we need to be aware of in regards to his/her participation in this program? Is there anything that may impact others in the program we need to be aware of?*
example - Behavioural or Medical concerns
In the case of accident or illness, I authorize the caregiver to administer first aid and/or be taken to the nearest emergency centre. I consent for my child to receive medical treatment. I consent that in the event of severe injury or illness the means of transportation may be ambulance at a cost to myself.*
Parent/Guardian Signature*

I declare that the information which I have provided on this form is complete and correct and that I will notify the program if any changes occur. I authorize the facilitator who is with my child to consent, where it is impractical to communicate with me, for my child to receive such medical or surgical treatment as may be deemed necessary. Clear
COVID 19 RELEASE OF LIABILITY, WAIVER OF CLAIMS, ASSUMPTION OF RISKS AND INDEMNITY AGREEMENT

BY SIGNING THIS DOCUMENT YOU WILL WAIVE CERTAIN LEGAL RIGHTS, INCLUDING THE RIGHT TO SUE.
Legal Guardian Name:

First NameLast Name
Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Participant/Child Name:

First NameLast Name
ASSUMPTION OF RISK:

I/ we, the undersigned, are aware that:

(a)   the Province of British Columbia has declared a State of Emergency as a result of the Covid 19 pandemic;

(b)   the Provincial Health Officer has provided guidelines for the prevention and control of Covid 19, and ELEVATION OUTDOOR EXPERIENTIAL PROGRAMS ASSOCIATION (“Elevation”) is offering outdoor experiential programs to children, with rules and procedures in place to follow the provincial guidelines, however Elevation cannot and does not guarantee that the Participant will not come into contact with the Covid 19 virus as a result of participating in Elevation Programs;

(c)   participating in the programs provided by Elevation involves inherent risks as a result of the interaction between participants, instructors, and other people, shared equipment, and excursions to public spaces, including the risk of exposure to the Covid 19 virus, and the risk of contracting and spreading the Covid 19 virus, and any related infections or complications;

(d)   if Elevation has reason to believe that the Participant has been exposed to the Covid 19 virus, or is showing any symptoms of the Covid 19 virus, Elevation will not allow the Participant to continue participating in the Elevation programs, and will not be able to provide a refund, if applicable, for any paid spots in Elevation programs.

I/we are the parent(s) or legal guardian of the Participant. I/we are aware that participating in programs provided by Elevation involves an inherent risk of contracting and/or spreading the Covid 19 virus. I am also aware that the risks, dangers and hazards referred to above exist throughout the entire duration of the Elevation programs, and that the Participant may remain asymptomatic for an extended period of time after participating the Elevation programs, even though the Participant may have come into contact with the Covid 19 virus, and the Participant may be contagious.

I/ we confirm that Elevation has made no representations, warranties or other assurances with respect to the safety of participating in Elevation programs and has warned me of the risks associated with the Participant participating in Elevation programs. I/we freely accept and fully assume all such risks, dangers and hazards and the possibility of infection, illness, associated medical complications, personal injury, death, mandatory quarantine or self-isolation measures to the Participant and the Participant’s household or family members, as well as damage or loss, resulting therefrom.

I/we acknowledge and agree that this waiver will continue to apply even if the Provincial State of Emergency is lifted, and that Elevation reserves the right to refuse participation for anyone based on a suspected case of COVID-19 or suspected exposure to it, or if any Participant refused to follow safety protocols.

RELEASE OF LIABILITY, WAIVER OF CLAIMS AND INDEMNITY AGREEMENT

In consideration of the Participant being permitted to participate in Elevation programs, I/ we hereby agree as follows:

1. TO WAIVE ANY AND ALL CLAIMS that I/we have now or may in the future have against Elevation in connection with the Participants participation in Elevation programming, including Elevation’s directors, officers, employees, agents, and representatives (all of whom are hereinafter collectively referred to as the “RELEASEES”);

2. TO RELEASE THE RELEASEES from any and all liability for any loss, damage, injury or expense that I/we or the Participant may suffer as a result of the Participant participating in Elevation programs due to Covid 19, 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 OWED UNDER THE OCCUPIERS LIABILITY ACT, R.S.B.C. 1996, C.337, ON THE PART OF THE RELEASEES;

3. TO HOLD HARMLESS AND INDEMNIFY THE RELEASEES from and against any and all claims, actions, damages, liability and expenses in connection with loss of life, personal injury sustained or damages arising from the Participant participation in Elevation programs, including the loss of any registration fees, and to indemnify Elevation from and against any claims that the Participant may have, now or in the future, against Elevation as a result of the Participant participating in Elevation programs; and

4. This agreement shall be effective and binding upon my/our heirs, next of kin, executors, administrators, assigns and representatives in the event of my/our death or incapacity.

In entering into this Agreement, I/we am not relying upon any oral or written representations or statements made by the Releasees other than what is set forth in this Agreement.

I/WE HAVE READ AND UNDERSTAND THIS AGREEMENT AND I/WE ARE AWARE THAT BY SIGNING THIS AGREEMENT I/WE ARE WAIVING CERTAIN LEGAL RIGHTS WHICH I/WE OR MY/OUR HEIRS, NEXT OF KIN, EXECUTORS, ADMINISTRATORS AND ASSIGNS MAY HAVE AGAINST THE RELEASEES.

This agreement must be completed in full, signed, dated and witnessed before visiting the Property.
Signed on the date of:

MonthDayYear
Date
Signature of Legal Guardian:

Clear
Name of Witness:

First NameLast Name
Signature of Witness:

Clear
Payment

APPLICANT MUST SELECT WEEK BELOW so we know which camp applicant will be attending.
1. July 10 - 14
2. July 17 - 21
NEW! July 24 - 28
3. July 31 - Aug 4
4. Aug 21 - 25
*Please ensure you have selected '1' in My Products below, after 'Please select the number of weeks you are registering your child for'. This will allow you to pay for camp spot before submitting this application.

**Your childs spot in a camp will only be secured if payment is processed through this application.

My Products*

Intro to Adventure Summer Camp$375.00CAD

Please select the number of weeks you are registering your child for.

Total $0.00CAD

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Date of Submission*

MonthDayYear
Date
Should be Empty:

Intro to Adventure Summer Camp Application 2023

Intro to Adventure Behaviour Agreement

Intro to Adventure Permission Form

Participants Medical Form

Medical History

COVID 19 RELEASE OF LIABILITY, WAIVER OF CLAIMS, ASSUMPTION OF RISKS AND INDEMNITY AGREEMENT

Payment