Language
  • English (UK)
  • Image
  • CAMPER REGISTRATION FORM

    ZGŁOSZENIE NA KOLONIE I OBÓZ HARCERSKI 
  • Please ensure you have read the camp info documents before filling out this form. 

  • 1. Camper Information - (one child per registration form)

  • Browse Files
    Drag and drop files here
    Choose a file
    Cancelof
  • 2. Parent/Guardian Information

  • 3. Emergency Contact Information

  • 4. Camper Health Information 

  • Informed Consent and Acknowledgement

    I acknowledge the unique approach of developement and education through the scouting method and grant permission for my child's participation in activities that follow this method. I confirm that my child is allowed to participate in all activities, except for those that indicated in the medical notes. I have thoroughly read the information documents, and am well-versed in the rules and regulations, visiting hours, as well as the accommodation and childcare details.

    I hereby give my approval for my child’s participation in any and all activities prepared by ZHR Polish Scouts of Canada during the selected camp.

     

    Release of Liability and Waiver and Consent for Use of Photographs

    By signing this document, I acknowledge that I release ZHR Polish Scouts of Canada, its agents, employees, instructors, volunteers and all other representatives from any claims, demands, actions, liability, damages, or causes of action arising from any loss, injury, or damage that myself or my child may suffer while participating in any program or activity of ZHR Polish Scouts of Canada, in excess of the insurance policy purchased by the organization. Additionally, I understand that photos, videos, and voice recordings may be taken of myself or my child during scouting activities, and I consent to the use of these materials in promotional materials and publications without further notice to me.


    I have read and fully understand the nature of this document and fully understand and accept the contents of this Release of Liability and Waiver and Consent for Use of Photographs and are executing this document voluntarily in full knowledge of its legal effect.

  • Powered by Jotform Sign Clear
  • Medical Release and Authorization

    I understand that children often get minor scrapes or cuts during outdoor activities, which can be easily treated with basic first-aid. In such cases, parents will not be contacted. Our trained staff will ensure that the injury is appropriately addressed with necessary treatment and proper care. However, in the unlikely event of an emergency where a child requires medical attention, we will immediately contact the parent or guardian. Our top priority is the wellbeing of our campers, and we assure parents that we will take every necessary measure to ensure their child's safety in any situation.

    As Parent and/or Guardian of the named camper, I hereby authorize the diagnosis and treatment by a qualified and licensed medical professional, of the minor child, in the event of a medical emergency, which in the opinion of the attending medical professional, requires immediate attention to prevent further endangerment of the minor’s life, physical disfigurement, physical impairment, or other undue pain, suffering or discomfort, if delayed.

    Permission is hereby granted to the attending physician to proceed with any medical or minor surgical treatment, and x-ray examinations. In the event of an emergency arising out of serious illness, the need for major surgery, or significant accidental injury, I understand that every attempt will be made by the attending physician to contact me in the most expeditious way possible. This authorization is granted only after a reasonable effort has been made to reach me.

    Permission is also granted to the ZHR Polish Scouts of Canada to provide the needed first aid and emergency treatment prior to the child’s admission to the medical facility.

    Release authorized on the dates and/or duration of the registered season. This release is authorized and executed of my own free will, with the sole purpose of authorizing medical treatment under emergency circumstances, for the protection of life and limb of the named minor child, in my absence.

  • Image
  • Electronics Policy

    At our summer camp, we have a no electronics policy to ensure that our campers fully engage with the outdoors and each other. We believe that unplugging from technology can help promote social interaction, creativity, and self-discovery. We ask that campers leave all electronics at home, including cell phones, tablets, laptops, and gaming devices.

    We understand that some campers may feel uneasy about being without their devices for an extended period, but we assure you that our activities and programs will keep them engaged and entertained. Campers who bring electronic devices will be asked to turn them in to camp staff for safekeeping until the end of the session.

    There may be some situations where a camper needs to use a phone, such as for emergencies or to call home, and in those cases, they may ask a staff member for assistance. We appreciate your cooperation in helping us maintain a technology-free environment for our campers.

  • Payment

    To secure a place for your child at our summer camp, we require payment in full at the time of registration. Every additional child attending camp in the same family recieves a discount of $100.

    Send payment via e-transfer to:
    kaszuby@zhr-kanada.org

    Or send a check payable to ZHR Polish Scouts of Canada in the mail to the below address:

    dhna Elżbieta Łyszkiewicz
    207 Wilmot Trail, Newcastle, ON, L1B 1A9

    We offer a discount of $50 for those who register with advance payment by May 31st.

  • BUS SCHEDULE

    July 8th, 2023 - Departure Times

    8:00 AM - Etobicoke 

    9:00 AM - Scarborough 

    10:15 AM - Peterborough

    July 22nd, 2023 - Arrival Times

    5:30 PM - Peterborough

    6:45 PM - Scarborough 

    7:30 PM - Etobicoke

  • Confirmation

    I confirm that I have carefully read and thoroughly understood the policies, rules, and regulations set forth by the summer camp. I acknowledge that it is my responsibility as a parent/guardian to ensure that my child fully understands and adheres to these policies during their stay at the summer camp.

    By submitting my child's application and enrolling them in the summer camp program, I give my full consent for my child's participation and agree to the terms and conditions set forth in the policies. I understand that this acknowledgement serves as a binding agreement between myself and the summer camp.

  • I acknowledge that any violation of the Camp Regulations listed below will result in immediate dismissal of the participant at the expense of the parents:

    • Failure to comply with the Scout Law, Camp Policies & Regulations
    • Possession and/or use of cigarettes, e-cigarettes, alcohol or drugs
    • Continual disruption of the camp's program 
    • Being in danger of harming oneself or another camper
    • Leaving the camp area without permission or inviting unauthorized guests
    • Going to another sub-camp or tent without permission
    • Disobeying superiors or continuous refusal to participate in activites, using vulgar language or cursing


    In the event that a child cannot adapt to camp life, the parents will be notified, and their opinion will be sought regarding the child's possible departure from the camp.

    Parents will also be held responsible for any material damage caused by their child on the bus or within the camp.

    In agreeing to these terms, I declare that I have read and understood the participant's commitment and Camp Regulations and agree to comply with them.

    BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.

  •  - -
    Pick a Date
  • Powered by Jotform Sign Clear
  • Should be Empty: