Weekend Program Detailed Registration Form

Weekends on the Trail: Program Registration

2024-2025
I would like to register my participant for

Session 1 (September 21st - December 7th)Session 2 (January 4th - March 15th)Session 3 (March 22nd - June 7th)Sessions 1, 2, 3 (September 21st - June 7th)

Participant's Information
Participants Name

First NameLast Name
Birth Date

MonthDayYear
Sex

MaleFemaleOther
Address

Street Address

CityState / Province

Postal / Zip Code

Parent/Guardian Information
Mother's Name

First NameLast Name
Mother's Profession
Mother's Cell Phone Number
Mother's e-mail
example@example.com
Father's

First NameLast Name
Father's Profession
Father's Cell Phone Number
Father's e-mail
example@example.com
Home Phone Number
Parental Marital Status

MarriedDivorcedWidowedRemarriedOther
Name of Step Parent

First NameLast Name
Step Parent Phone Number
Name of Guardians if camper is in Foster Care

First NameLast Name
Guardians Phone Number
Guardians e-mail
example@example.com

Emergency Information
Emergency Contact's Name

First NameLast Name
Relationship
Phone Number
Alt. Phone Number
Campers Medicare card number and expiration date*
Allergies, chronic illness, or medical conditions? If yes, please describe.*
**A separate camper health form must be filled out prior to the start of camp****Please notify the camp if there are any changes to the camper’s medical history after completing these forms**

Participant Information
What are your participant's interests, special skills (does he or she like sports, art related activities, music, games, what are their fears, dislikes, ect...)
Please explain in as much detail as possible about your participant's emotional and intellectual development and specific difficulties. The clearer understanding we have of your child, the better we can adapt a wonderful summer program to meet his/her specific needs.
Please include a picture of your participant's

Cancelof

Conditions of Enrollment Weekends 2023

Note: Trails Recreation Center will hereafter be referred to as 7730616 Canada Association(abbreviated 7730616).

All participants above the age of four who are not completely toilet trained may come to the program, but must be accompanied by their own shadow.

1b) The child must be able to communicate in some way that he/she needs the washroom.

Cost Breakdown (12 weekends per session)

Session 1 (October 7th- December 23rd): $720.00 (parents will pack a lunch, participants will receive snacks, all supplies necessary for activities).

Dates for session 1:
October 7

October 14

October 21

October 28

November 4

November 11

November 18

November 25

December 2

December 9

December 16

December 23

Session 2 (January 6th - March 23rd): $720.00 (parents will pack a lunch, participants will receive snacks, all supplies necessary for activities).

Dates for session 2:

January 6th

January 13

January 20

January 27

February 3

February 10

February 17

February 24

March 2

March 9

March 16

March 23

Session 3 (April 6th - June 15th): $720.00 (parents will pack a lunch, participants will receive snacks, all supplies necessary for activities).

Dates for session 3:

March 30

April 6

April 13

April 20

April 27

May 4

May 11

May 18

May 25

June 1

June 8

June 15

All Sessions 1,2 &3: (October 14th - June 15h): $2160.00 (parents will pack a lunch, participants will receive snacks, all supplies necessary for activities).

PAYMENT OPTIONS:

You can send a check to Trails Recreation Center

6800 Macdonald Cote St. Luc #303

H3X3Z2

OR send an e-transfer to sheldonpronman@yahoo.com with the security word being camp [ all in small letters].

7730616 (Trails Recreation Center) has the right to terminate a participants stay should they become danger to himself or herself or others.
*This includes if the child requires more care than the director feels the staff is able to provide. No refund will be issued.

By signing this document, parents authorize the use of any photographs or other forms of media taken of the children during their time at the the center for publicity purposes such as brochures. All materials used will remain the property of 7730616.

At Trails Recreation Center, we continue to strive to make each participant stay safe and magical with memories to last a lifetime!

Can’t wait to see ya on the trail!
Date

MonthDayYear
Date
Signature*

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Parents agree to release and indemnify 7730616 Canada Association doing business as Trails Recreation Center, owner, director and all other staff from any and all claims for damages arising as a result of any accident, injury or otherwise sustained by the here in named child arising from participation in activities, wherever they may be, either on or off camp property
Campers Name

First NameLast Name
Parent/Guardian Name

First NameLast Name
All parties agree that the language of this contract is in English.
Date

MonthDayYear
Date
Signature of parent or Guardian*

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Les parents acceptent de ne pas engager de poursuites judiciaires contre 7730616 Canada Association, Trails Recreation Center le propriétaire, le directeur et tous les employés, résultant de dommages survenus lors d'un accident quelconque ou d'une blessure subie par l'enfant participant a l'une ou l'autre des activités, qu'elle soit survenue sur les lieux du camp ou a l'extérieur de ceux-ci.
Nom de l'enfant

First NameLast Name
Nom du parent our tutuer

First NameLast Name
Toutes les personnes acceptent que la langue de ce contrat soit en anglais.
Date

MonthDayYear
Date
Signature du parent ou tuteur*

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Weekends on the Trail: Program Registration