New Customer Registration Form

PARTICIPANT REGISTRATION FORM
SPECIAL OFFER

Register for WEEK 1 at $220 and receive $50 off AN ADDITIONAL WEEK.
Basic bicycling skills are required.
No training wheels.

At no additional charge, overnight bicycle storage/lock-up is available.

Check Week(s) or Day(s) that you would like to register for:

Approximate Drop-off Time:
Approximate Pick-up Time:
PAYMENT METHOD:
For E-transfers Camp Olympics has auto-deposit. Please include the participants name in the “memo” line.
# of WEEKS blanks X $250 (HST included) = blank .
# of DAYS blanks X $55 (HST included) = blank .
PARTICIPANT INFORMATION:
Participant's Name:*

First NameLast Name
Gender:

MaleFemaleOther
Date of Birth: Please note that participants MUST BE 6 years of age (or turning 6 during the year of registration). Also must be able to ride a 2 wheeler on their own.

MonthDayYear
Date
Health Card #:
Swimming Ability:

BeginnerIntermediateAdvanced
Does your child have any allergies or medical concerns?

YesNo
If yes, please explain.
PARENT/GUARDIAN CONTACT INFORMATION:
Parent/Guardian's Name (1):*

First NameLast Name
Parent/Guardian's Address (1):*

Street Address

Street Address Line 2

CityProvince

Postal
Parent/Guardian's Phone Number (1):*
Parent/Guardian's E-mail (1):
example@example.com
Parent/Guardian's Name (2):*

First NameLast Name
Parent/Guardian's Address (2):*

Street Address

Street Address Line 2

CityProvince

Postal
Parent/Guardian's Phone Number (2):*
Parent/Guardian's E-mail (2):
example@example.com
EMERGENCY CONTACTS:

These will be the people who are allowed to pick up your child or who will be called if a parent/guardian cannot be reached in an emergency.
Emergency Contact's Name (1):*

First NameLast Name
Emergency Contact's Phone Number (1):*
Relationship to Child:
Emergency Contact's Name (2):*

First NameLast Name
Emergency Contact's Phone Number (2):*
Relationship to Child:
Are there any current issues which involve your child in terms of Court Orders, Custody Issues, and/or Restraining Orders?

YesNo
If yes, please speak with our program staff.
I give permission for my child to be photographed for promotional purposes and/or memories for the children.

YesNo
I give permission for my child to sign themselves in/out of Camp Olympics without an approved adult. *Please Note: selecting ‘Yes’ indicates that a participant will arrive and depart from camp at drop-off/pick-up times without a parent or guardian.

YesNo
Lice: If lice is detected on any participant at this site, we will advise parents/guardians by email. As well, all participants will be checked for lice. If you do NOT wish for you child to be checked, please indicated by checking the box.

No, thank you.
Sun Screen: It is a camp policy to allow staff to assist participants with the application of sun screen provided the following has been completed. (We recommend that the sun screen be waterproof, provide UVA/UVB protection and have a SPF of at least 30 and that it contain no peanut products.)

I, blanks , give permission for the staff of "Camp Olympics" to assist in the
application of sun screen to blank . I understand that adequate sun screen
coverage will be the full responsibility of myself, and not the staff. I also understand that I must provide a clearly labelled bottle of approved sun screen.
Please include any information that will make the staff better informed about your child. This information is confidential and will be used to meet any specific needs of your child.
AMATEUR ATHLETIC LIABILITY WAIVER

The undersigned and the undersigned’s heir, executors and administrators, hereby waive and forever release and discharge Camp Olympics Summer Sports Day Camp, it’s owners, trustees, officers, agents and employees of and from any and all claims, suits or rights for damages for personal property or physical injury which may be sustained or which occurs during participation in associated activities, whether or not such injuries or property damage or loss is caused by or connected to or arises out of any acts of Camp Olympics Summer Sports Day Camp, it’s owners, trustees, officers, agents and employees.

I have read and understand the above information:
Parent/Guardian Signature:

Clear
Date:

MonthDayYear
Date
Camp Olympics, 1094 Lakeshore Drive, North Bay, ON, P1A 2H3

If you have any questions, please feel free to contact us at 705-492-3731.
We look forward to having your child this summer! 

Thank you!
Should be Empty:

	Monday	Tuesday	Wednesday	Thursday	Friday	Full Week
Week 1: June 29-Aug 3 Closed July 1, 2026
Week 2: July 6-10
Week 3: July 13-17
Week 4: July 20-24
Week 5: July 27 -31
Week 6: Aug. 3-7
Week 7: Aug. 10-14
Week 8: Aug. 17-21
Week 9: Aug 24-28 pending school start date

PARTICIPANT REGISTRATION FORM

SPECIAL OFFER

PARTICIPANT INFORMATION:

PARENT/GUARDIAN CONTACT INFORMATION:

EMERGENCY CONTACTS: