Winter Break Camp 2025 Detailed Registration Form

Trails Recreation Center: Winter Camp Registration

Winter 2025
I would like to register my camper for

Winter Break Camp (December 30th 2024 to January 3rd 2025)
Does your camper require extended care from 3:00-5:00pm ($10.00 a day)

YesNo

Camper's Information
Camper's 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

Important Contact Information
Pediatricians/GP Name

First NameLast Name
Pediatricians/GP phone number
Social Worker's Name

First NameLast Name
Social Workers Phone Number

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**

Campers 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 Camper

Cancelof

Conditions of Enrollment Spring 2023

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

All campers above the age of four who are not completely toilet trained may come to camp, but must be accompanied by their own shadow.
1a) Camp fees will reflect accommodations for a personal shadow.

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

1c) Should a child begin camp without his or her own shadow and develop bathroom issues as time goes on, the parent will then be expected to provide the appropriate coverage in order for the child to remain at camp.

*Please note that children are taken to the washroom 5 times per day (9:30 am, morning snack, lunch, afternoon snack, and before dismissal).

Cost Breakdown

Winter Break Camp: $385.00 for the week

Payment is required in full by December 1st, 2024

PAYMENT OPTIONS:

You can send a check to 7730616 Canada Association

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 has the right to terminate a child’s stay at winter camp should the camper be found a 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.

**In the event the child in question has a private shadow, it will be reviewed on a case-to-case basis.

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 camp 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 child’s 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 any camp 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 du camp, 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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Trails Recreation Center: Winter Camp Registration