BBBSL Summer Camp 2025 Application

Big Brothers Big Sisters Langley
2025 Summer Camp Registration Form
Our camps offer children and youth a fun, supportive space to play, learn, and grow. Each week features a unique theme—encouraging creativity, curiosity, and connection through activities like multi-sports, STEM, art, cooking, and nature exploration.

More than just fun, our camps help kids build confidence, develop social-emotional skills, and make lasting friendships. With the support of our caring BBBSL Summer Staff, campers feel seen, supported, and part of a community.

For weekly themes, dates, and age requirements, please visit our website: https://langley.bigbrothersbigsisters.ca/summer-camp/

Please Note:
Our summer camps are group-based programs facilitated by a limited number of staff and volunteers. Because of this, we are unfortunately unable to provide continuous 1:1 support for individual participants during camp. Each camp week may include up to 20 children in a group setting. If your child requires continuous 1:1 support or has higher support needs to participate safely and successfully, please connect with us prior to registration. We’d be happy to discuss options, including whether you’re able to provide a support person to attend camp alongside your child. Our goal is to create a fun, inclusive, and supportive environment for every camper—and we’re here to work with you to help make that possible!

Summer Camp Registration Form – Important Information

Please note: Completing this application does not guarantee a spot in our summer camp. Space is limited for all camp weeks.

Once you submit this form:
- You will hear from a Big Brothers Big Sisters of Langley (BBBSL) staff member within 3-4 business days to let you know if your child has been accepted into a camp or placed on the waitlist.
- If your child is accepted, you will receive a confirmation email with instructions on how to submit the $70 registration fee.
- Payment is not collected through this form. Once accepted you will receive a link to complete payment, payment can be made by credit card, e-transfer, or Apple/Google Pay.
- Payment must be made within one week of receiving your acceptance email.
- If payment is not received within that time, your child’s spot may be offered to the next person on the waitlist.
Both this application and the registration fee are required to complete your child’s registration.

If you have any questions, please contact Britnee at britnee.brow@bigbrothersbigsisters.ca.

This form must be completed by the child's parent/legal guardian.
Child's Full Name*

First NameLast Name
Child's Gender/Pronouns*
Child's Date of Birth*

MonthDayYear
Date
Child's Grade this September*
Child's Current School*
Parent/Guardian Name*
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*
example@example.com
Cell Phone Number*

Area CodePhone Number
Home Phone Number (if applicable)

Area CodePhone Number
Please check all that apply: (Optional; for statistical purposes only)

IndigenousLow IncomeNew Immigrant/RefugeeFamily involvement with MCFD/Social WorkerMental Health Condition (Parent/Child)
Due to limited space, students will only be able to sign up for one week of camp. We will do our best to accommodate your child’s first choice but have asked you to select a second option in case that one you have first selected is full.
What week of summer camp are you looking to register your child for?
If the above camp is full, what is your second choice to register your child for?
Is there anything else we should know about your child that will help us support them to the best of our ability?
Does your child have any particular challenges or issues they are dealing with at this time?
Do you have any questions about the camps?
I, the legal guardian, of the above-mentioned child give Big Brothers Big Sisters of Langley permission to process my child's application and provide services to my child for the site-based group mentoring program. This consent shall remain in effect for the duration of my child's involvement with Big Brothers Big Sisters unless otherwise revoked.
Legal Guardian Name *
Date Signed*

MonthDayYear
Date
Legal Guardian Signature*

Clear

IN CASE OF EMERGENCY:

Emergency Contact (If legal guardian can't be reached this person is granted permission to pick up child and/or authorize emergency treatment)
Emergency Contact Name*
Relationship to Child*
Phone Number*

Area CodePhone Number
Are there any medical concerns, conditions, allergies, medications, food restrictions etc?*
Emergency Release

A. In case of accident, illness or surgical emergency to my child, and if I am not immediately available for consultation and consent, I HEREBY AUTHORIZE AND DIRECT the BBBSL staff/mentors to secure proper medical or other related treatment for my child. BBBSL Staff/mentors will not be responsible for transportation of my child to hospital. If I am not available to transport my child, the mentor has permission to call for an ambulance.
Initials Agreeing to Emergency Release A*

Clear
How will you child be getting home (ex. walking, picked up by parent/sibling/etc)? *
If there are any safety concerns or persons that may NOT pick up your child from camp, please note this below.
Big Brothers Big Sisters Langley does not provide transportation of students to or from the summer camp or any activities. If there are any special Field Trips planned where your child needs to be dropped off at a different location on a certain day, you will be notified. During the camps staff may take the children on a small walking field trip (to a local park, the spray park, etc). You will be notified of any of these excursions prior to them taking place. Big Brothers Big Sisters Langley needs the guardians/parent consent to take their child on a walking field trip in the neighbourhood.
I, (name of parent) blanks* will permit Big Brothers Big Sisters Langley staff to take my child, (name of child)blank* for walking field trips in the neighbourhood.
Parent/Guardian Name*
Date Signed*

MonthDayYear
Date
Guardian/Parent Signature*

Clear

INFORMED CONSENT (SITE BASED GROUP PROGRAM) - LEGAL GUARDIAN

I hereby give permission to Big Brothers Big Sisters of Langley to make available their service to my child. It is my understanding that the intention of the Agency is to offer my child an opportunity to participate in a group program lead by a responsible adult, (minimum 18 years old, however, where appropriate supervision takes place, the volunteer may be younger), I understand that all efforts will be made to select a responsible Mentor who will facilitate the group program.

In consideration for this service and other valuable consideration provided to my child by Big Brothers Big Sisters of Langley.I release the agency of all responsibilities and liabilities in connection to their services provided in good faith, to myself or my child. Ipermit the agency to release any relevant information, including my personal information, to Big Brothers Big Sisters of Canada and their insurers, as may be appropriate in connection with anylegal proceeding. inquiry or risk thereof.

I understand that the collection of personal information about me or my child will be held in strict confidence and is to be used solely for the purposes of administering the program. I further agree that information about my child may be shared. at the discretion of Big Brothers Big Sisters of Langley. with the group facilitator so that my child's needs may be best met.

I understand that this application is the property of Big Brothers Big Sisters of Langley. Talso agree that my child will participate in the Pre-Match Training Program administered by Big Brothers Big Sisters of Langley.

I HAVE READ AND UNDERSTAND THIS AGREEMENT. BY SIGNING THIS AGREEMENT, I ACKNOWLEDGE THAT:

I, the parent/guardian request Big Brothers Big Sisters service for the above-mentioned child. I give my child permission to participate in one or more group programs offered by Big Brothers Big Sisters of Langley. I am aware of and understand the risks, dangers and hazards associated with the above service and agree such service is suitable for my child.
Date*

MonthDayYear
Date
Parent/Guardian Name *
Parent/ Guardian Signature*

Clear

Big Brothers Big Sisters of Langley – Summer Camp Behaviour Agreement
At BBBSL, we are committed to creating a safe, welcoming, and inclusive environment where every child feels respected, valued, and free to be themselves. To support this goal, we ask all families to review and acknowledge the following Behaviour Agreement.

We want every child to have a positive and fun camp experience! To help make that possible, participants are expected to:

Be Respectful – Show respect to themselves, fellow participants, BBBSL staff and volunteers, and all camp property.
Be Kind and Inclusive – Treat others with kindness and acceptance, creating a space where everyone feels like they belong.
Listen and Participate – Pay attention to instructions from camp leaders and engage positively with the group.
Keep a Positive Attitude – Approach each activity with an open mind and a willingness to try, learn, and have fun.

These expectations are similar to those in a school setting. When followed, they help ensure a safe and enjoyable experience for everyone. If a participant has difficulty meeting these expectations, BBBSL staff will work with them and their parent/guardian to support improvement. However, repeated or serious inappropriate behaviour may result in restricted participation or removal from camp.

Parent/Guardian Acknowledgment:
I have read and understand the BBBSL Behaviour Agreement outlined above. I confirm that I have reviewed these expectations with my child. I understand that these guidelines are in place to ensure the safety and well-being of all participants, and I acknowledge that failure to follow them may result in my child being removed from the camp program.
Signature*

Clear

MEDIA CONSENT FORM - CHILD/YOUTH
Name of Child*
I hereby consent to Big Brothers Big Sisters of Canada (National Office) and its associated member Big Brothers Big Sisters of Langley the use of any photographs, audio and/or video recordings of my child or youth as taken or produced by media personnel and/or National Office or Local Agency staff at recreational events or match outings, or otherwiseauthorized by the National President & CEO, local agency Executive Director or Board of Directors, and that this media may be used by Local Agency and/or by the National Office for purposes of promotional material including brochures, posters, newsletters, media information, advertisements, audio-visual productions and digital media, (such as the local agency websites and social media). Photographs or video productions may also be shared with community and school partners for program promotion.
Child first name only may be used:

YesNo
Child full name may be used:

YesNo
Note: Confidentiality concern

Please check here if you do not want your picture or your child's picture used or if you have a safety concern.
Parent/Guardian Name*
Parent/Guardian Signature*

Clear
Note: It is the parent/gaurdians responsiblity to inform BBBSL if the status of this consent changes.

Please Note:
Payment will not be collected through this form. Once your application is received, BBBSL staff will follow up with you within 3-4 business days via email to let you know if your child has been offered a spot or placed on the waitlist.

If your child is offered a spot, it will be a conditional acceptance until payment is received. This email will include full instructions on how to submit the $70 registration fee, which can be paid by credit card, e-transfer, or Google/Apple Pay.

Your child's spot is not secured until the registration fee has been received.
If payment is not received within one week of your acceptance email, your child(ren)’s spot may no longer be available if there is a waitlist. Application and registration fee payment are both required to have a final confirmation that your child is enrolled in BBBSL Summer Camps.*

I agree.
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Big Brothers Big Sisters Langley 2025 Summer Camp Registration Form

Big Brothers Big Sisters Langley
2025 Summer Camp Registration Form