Spring Break Camp 2026 Registration Form

Spring Break Camp 2026 Registration Form
Child's Name:*

First NameLast Name
Age Group: *
*THERE IS ONLY ROOM IN OUR 13-16 YEAR OLD TEEN GROUP AT THIS TIME*.
Child's Birthday:*

MonthDayYear
Date
Child's Age (at the time Spring Break Camp starts):*
Child's Status Number:*
Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Seymour Mail BoxesEslha7an CentreMission 4-WayNo Bus Service Needed
Does your child have any allergies?*
If your child has any allergies please list them below:
Does your child have any medical conditions we should know about? *
If your child has any medical conditions please list them here:
Does your child have any behavioral exceptionalities we should know about? *
If your child has any behavioral exceptionalities please list them here:
Does your child have a 1-1 support worker at school?*
Does your child require 1-1 support or extra support while at CJMC’s Spring Break Camp? *
PARENTS/GUARDIANS/SAFE ADULTS AND EMERGENCY CONTACT INFORMATION
Adult #1 Name*

First NameLast Name
Adult #1 Phone Number*
Adult #1 Email*
example@example.com
For effective and timely communication during camp days we create a Facebook messenger group chat for parents/guardians. It is not required, but it is beneficial to receive updates in real time. If you would like to be added to the group please provide your Facebook Messenger Name:
Adult #2 Name*

First NameLast Name
Adult #2 Phone Number*
Adult #2 Email*
example@example.com
Adult #2 Facebook Messenger Name
Emergency Contact Name*

First NameLast Name
Emergency Contact Phone Number*
Relationship to child:*
SPRING BREAK CAMP 2026 RULES AND EXPECTATIONS

PLEASE TAKE THE TIME TO THOROUGHLY READ THE FOLLOWING AND PLEASE GO OVER THE FOLLOWING WITH YOUR CHILD EACH MORNING BEFORE CAMP.
1. Follow all Spring Break Camp rules and instructions given by leaders/staff/bus drivers/facilitators.

2. Attendance is required all 4 days. Your child gets 4 days at Camp. 13-16 year olds get 2 days. If your child is unable to attend, please inform us no later than 7:30am the morning of, or the day before if possible.

3. Stay within leaders sight and with the group at all times, while at CJMC and while out on field trips.

4. Respect others. Including other peoples: personal space, belongings, feelings and bodies (no hitting, kicking, throwing things or anything that causes physical harm to other kids or leaders/staff).

5. Verbal abuse or inappropriate language will not be tolerated at Spring Break Camp (such as calling someone mean names, sticking up the middle finger at someone, making the L symbol to call someone a "Loser", taunting other children, etc.).

Verbal or physical abuse and threats towards our Spring Break Camp Leaders/staff/bus drivers/outside facilitators or other children will not be tolerated. We experienced this at previous camps. A child will be asked to miss the following days activity if this happens at Spring Break Camp.

6. No inappropriate behaviour such as: inappropriate touching, noises, language, or discussions will be tolerated while at Spring Break Camp.

(For example: no sharing bathroom stalls, no kissing, no touching or showing of other childrens or their own genitals, no swearing, no sexual moaning or language, no sexualized dancing (twerking), no hiding in secluded areas away from leaders, etc. These are all things we have personally witnessed at previous CJMC camps and programs).

7. No bullying of any form will be tolerated, whatsoever. To other children or to our CJMC Spring Break Camp staff/leaders.

8. Respect all CJMC/Spring Break Camp staff, property and equipment; as well as our facilitators and property at the locations we will be visiting.

10. Follow all bus rules and listen to bus drivers and leaders while on the bus. Bus rules are: No eating or drinking on the bus, no standing on the bus, must be seated at all times, must stay buckled on the bus until told to unbuckle, no switching seats on the bus while bus is in motion, no yelling/swearing/inappropriate language or spitting on the bus, no writing inappropriate pictures or words on the bus windows, no littering on the bus, no yelling or screaming on the bus.

RULE BREAKING:

We want to keep every child safe and for them to have fun while at Spring Break Camp. It is also important that our Camp Staff and external faciltiators are respected. Please talk to your child about the above rules each morning before Camp. Please emphasize we are the ones taking care of them and keeping them safe, so it's important they listen to us and stay with us throughout the entire time at Camp. Please tell your child that they are safe to come and talk to any of our Spring Break Camp staff about anything while at Camp.

If a child is consistently not listening, or being disrespectful or physically harmful to our Spring Break Camp staff, leaders, bus drivers, external facilitators, or other children...we reserve the right to ask that child to not participate in the next day's activity. There needs to be consequences to these type of actions listed above. Spring Break Camp is a privilege. Please consent by checking below that you've read all of the above, and that you have gone over it with your child. We want our Camps to be a fun, safe, fair, inclusive environment for all. Huy chexw a for taking the time to read this.
Yes I have
Parent/Guardian/Trusted Adult Consent
Please read:

I hereby give my approval for my child’s participation in any and all activities prepared by Squamish Nation. In exchange for the acceptance of said child’s candidacy by Squamish Nation, I assume all risk and hazards incidental to the conduct of the activities, and release, absolve and hold harmless Squamish Nation and all its respective officers, agents, and representatives from any and all liability for injuries to said child arising out of traveling to, participating in, or returning from selected program sessions.

In case of injury to said child, I hereby waive all claims against Squamish Nation including all leaders, staff, affiliates, all participants, sponsoring agencies, advertisers, and, if applicable, owners and lessors of premises used to conduct the event. There is a risk of being injured that is inherent in all activities. Some of these injuries include, but are not limited to, the risk of fractures, paralysis, or death.
For photos/videos of my child to be taken, and to be shared on social media, including but not limited to Facebook, Facebook Live, Instagram, Instagram Reels, CJMC Promo, etc. Also for possible use on Squamish Nation or external social media pages, etc.For my child to go on field trips located off of CJMC property.For my child to be given children's medication if needed (Children's: Tylenol, Advil, Allergy meds, Ginger Gravol or kids Gravol, etc.).
Parent Confirmation
BY ACKNOWLEDGING AND SIGNING BELOW, I AM AGREEING TO ALL OF THE ABOVE, AND I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THIS ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.
Type Full Name*
Signature*

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Spring Break Camp 2026 Registration Form

PARENTS/GUARDIANS/SAFE ADULTS AND EMERGENCY CONTACT INFORMATION

SPRING BREAK CAMP 2026 RULES AND EXPECTATIONS

Parent/Guardian/Trusted Adult Consent

Parent Confirmation