Compassion Camp Registration Form

Compassion Camp Registration Form

Changing the World with Lovingkindness, is a full day summer camp for kids in kindergarten to grade six. It is sponsored by the Prairie Centre for Ecumenism. It will run from 9am-4pm daily, August 6-9, 2024 at Grace Westminster United Church, Saskatoon. The registration fee is $75 per camper, payable by cheque, cash or e-transfer to the Prairie Centre for Ecumenism (admin@pcecumenism.ca) Our mail address is 2617 Clarence Ave S, S7J 1M5. For more information, please visit our website at www.pcecumenism.ca or our Facebook page @pcecumensim.
We are dedicated to promoting and facilitating Christian unity across denominations. We seek to accomplish our goal of visible reconciliation and unity through engaging in dialogue and offering programs and conferences designed to facilitate education, connection and inspiration.
Camper Information

Please submit one form per camper
Camper Name*

First NameLast Name
Current School Grade*
Date of Birth*

MonthDayYear
Age:
Health Card Number
Family Doctor

First NameLast Name
Allergies or Other Medical Conditions:*
Is there anything that we need to know about your child to help them have a successful week?
We are able to provide care in the morning starting at 8:30am. For which days does the camper require before camp care?

TuesdayWednesdayThursdayFridayBefore camp care not required
We are able to provide care at the end of the day until 4:30pm. For which days does the camper require after camp care?

TuesdayWednesdayThursdayAfter camp care not required

PARENT/GUARDIAN INFORMATION
Parent/Guardian Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityProvince

Postal Code
Home Phone Number
Business Phone Number
Cell Phone Number*
E-mail*
example@example.com
Do you have legal custody of the child who is being registered?*

YesNo
Name(s) of person(s) who may pick up your child from Camp Compassion
Home Church (if applicable)
Emergency Contact (other than the parent above)

In the case that we are unable to reach you in an emergency, please provide the name and number of someone we can contact (other than the parent above).
Emergency Contact Name*

First NameLast Name
Emergency Contact Number*

Application Consent
I understand and acknowledge the following:

Emergency Contact Information: I have provided accurate emergency contact information, including my contact number, an alternate contact person, and their contact details. In case of any emergency, I authorize the camp staff to contact me or the designated alternate contact.
Medical Authorization: I authorize the camp staff to seek and obtain necessary medical treatment for my child/ward in the event of illness, injury, or any other medical emergency. I understand that the camp staff will make every effort to contact me or the emergency contact person before seeking medical treatment, but they may proceed with necessary medical care if deemed urgent.
Camp Rules and Expectations: I have reviewed and discussed with my child/ward the rules, expectations, and code of conduct for the Church Camp. I understand that my child/ward is expected to adhere to these guidelines throughout the camp duration.
Photo and Video Release: I grant permission for photographs and videos of my child/ward to be taken during the camp for promotional, educational, and archival purposes by [Name of Church]. I understand that these images may be used in printed materials, online media, and presentations related to the Church Camp.
Transportation: I authorize the camp staff to provide transportation for my child/ward as necessary during the camp activities. I understand that all safety precautions will be taken during transportation.
Liability Release: I release The Prairie Centre for Ecumenism, its staff, volunteers, and affiliates from any liability for injuries, accidents, or loss of personal property that may occur during the Church Camp.
By signing below, I confirm that I have read, understood, and agree to the terms and conditions outlined in this consent form. I hereby give my permission for my child/ward to participate in the Church Camp and engage in all planned activities.
Parent/Guardian Name:

First NameLast Name
Date

MonthDayYear
Date
Signature

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Compassion Camp Registration Form

Camper Information

PARENT/GUARDIAN INFORMATION

Emergency Contact (other than the parent above)

Application Consent