Waiver & Consent Form
To be completed by Camper's Legal Guardian
I have made an informed decision for the above-named child to participate in IMJM-C’s Summer Youth Camp to be held at YMCA Cedar Glen, 13300 11th Concession Road, Schomberg, ON L0G 1N0, Ontario.
IMJM-C will take all reasonable precautions to ensure the safety and security of my child. I understand, however, that participation in an overnight summer camp carries risks. I acknowledge that this Waiver and Release of Liability will be used by IMJM-C, its affiliates and the organizers, collaborating organizations, teachers and volunteers of the Camp (the Releasees) and that it will be binding on you (the Releasor) as follows:
The Releasor hereby waive, release and forever discharge the Releasees from any and all liability for any death, disability, personal injury, property damage, property theft or loss, expense or actions of any kind which may hereafter accrue to my child during the Camp, for any cause whatsoever, and waive any and all claims, causes or actions or demands against the Releasees.
The Releasor agree to indemnify and hold harmless the Releasees from any and all liabilities or claims made by other individuals or entities as a result of my child’s actions during the Camp.
I hereby consent for my child to receive medical treatment, which may be deemed advisable in the event of injury, accident and/or illness during the Camp.
I consent to IMJM-C using my and my child’s information for the purposes of maintaining communications with me or my child. To revoke this authorization, I must notify IMJM-C in writing. Electronic information provided during registration will be stored on Google servers, Form software and/or the personal computers of our volunteers; written medical information will be summarized and/or shared only with appropriate staff, volunteers, and/or licensed practitioners in order to ensure the safety of my child. Your information will not be shared with or sold to any third party except as required by YMCA Cedar Glen policies or as required by law.
I agree to allow photographs or video of Camp activities, which may include images of my child, to be used for online and/or in-print promotional materials, such as website, social platforms, or brochures, for future IMJM-C camps.
I understand that dangerous or disruptive behaviour by my child may result in IMJM-C recommending that my child be removed from Camp early, at my own expense. Such circumstances will be discussed with the parent / guardian in order to ensure safe transfer of care of my child.
I understand if I cancel my child's registration greater than 60 days before the start of camp, a $100 cancellation fee will be applied & the balance will be reimbursed. I understand that the camp fee is fully non-refundable if cancelled less than 60 days before the start of camp.
I understand that if camp is cancelled for any reason by IMJM-C or by YMCA Cedar Glen, then I am entitled to a full refund, however I cannot claim any additional damages, losses, or childcare expenses from the Releasees.
I hereby certify that I have read this Waiver and Release of Liability, understand its contents and am aware of what I am agreeing to.