• K'aayxada Adventure Camp Registration Form

    K'aayxada Adventure Camp Registration Form

    Step 1: Complete this online form. You will need the Student present for this process. Step 2: When you receive the email confirmation, forward that email to the Student's teacher.
  • General Information

  • Student Date of Birth*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Emergency Contact

  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Student Physical Information

  • Does the student have any physical limitations?*
  • How is the Student's eyesight? If the Student is dependent upon glasses or contacts for adequate vision, please send an extra set*
  • Does the student have any psychological limitations (e.g. fear of water or heights)?*
  • Please indicate the students swimming ability*
  • Does the student take any medications (prescription or nonprescription e.g. Advil or Tylenol)?*
  • If the Student needs pain management or medication at camp, which of the following can they take (select all that apply):*

  • Do we have your permission to administer the above medications to your Student as needed?*

  • Has the Student been under a doctor’s care in the past 12 months?*
  • Does the Student have any allergies?*
  • Are any of the above life-threatening allergies?
  • Is an Epipen required for this allergy? If yes, the Student must bring an Epipen to camp and should carry it with them at all times.
  • Does the Student have any chronic medical conditions or illnesses?*
  • Please indicate all those that apply*

  • Does the Student have a history of joint injury?*
  • Please indicate all those that apply*

  • Student Dietary Information

  • Does the Student have any food allergies?*
  • Does the Student have any special food restrictions?*
  • Student Information Signatures

  • I certify that the above information is accurate and that, to the best of my knowledge,

  • is in good health, free of communicable disease, and
    physically able to participate in all K'aayxada Adventure Camp activities, except as noted above for physical or medical reasons only.

  • Date of Signature*
     - -
    2 digit month, 2 digit day, 4 digit year
  • PARTICIPANT AGREEMENT AND ACKNOWLEDGEMENT OF RISKS

    This section must be completed by both the Student and a Parent/Guardian. Please read this section together.
  • In consideration for my acceptance and participation in a part-day or day-long activity with the K’aayxada Adventure Camp Society, I will carefully read this entire document. I will enter my correct legal name and I will carefully question and clarify every issue, so I can understand, agree with, and sign this complete document.


    UNDERSTANDING AND ACKNOWLEDGMENT OF RISK: 

    I understand and acknowledge that the activity I am about to voluntarily engage in bears certain known and unanticipated risks that could result in injury, illness, disease, death, other physical and mental damage to myself, other participants and spectators, and also damage and loss of property. I also understand and acknowledge that my participation in these activities and their associated risks may result in personal claims against me by other third parties.  


    These risks include but are not limited to:  

    a. Walking, swimming, and operating boats in and around lakes, tidal channels, oceans and surf.
    b. Walking, hiking and climbing in and around mountains, forest and other wilderness environments.
    c. Operating tools and equipment used in the construction of trails and boardwalks.
    d. Operating in the widest possible range of weather conditions.
    e. Latent or apparent defects or conditions in equipment supplied by the K’aayxada Adventure Camp Society.
    f. Use or operation of equipment supplied by the K’aayxada Adventure Camp Society.
    g.Acts of other participants.
    h. Any first aid, emergency treatment or any other services provided.

     

    I understand and acknowledge that the above list of activities and risks is not complete or exhaustive, and that other known or unknown, identified or unidentified, anticipated or unanticipated risks may cause injury, illness, disease, death or other damage and loss to myself, other third parties and property.

  • Date of Signature*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Date of Signature*
     - -
    2 digit month, 2 digit day, 4 digit year
  • RELEASE OF LIABILITY, WAIVER OF CLAIMS, ASSUMPTION OF RISKS AND INDEMNITY AGREEMENT 

  • (hereinafter referred to as the “Release Agreement”) 

    BY SIGNING THIS DOCUMENT YOU WILL WAIVE OR GIVE UP CERTAIN LEGAL RIGHTS, INCLUDING THE RIGHT TO SUE OR CLAIM COMPENSATION FOLLOWING AN ACCIDENT 

    PLEASE READ CAREFULLY! 

    The term “Wilderness Activities” used herein means all services provided or arranged for me by the K’aayxada Adventure Camp, including without limitation all: guided boat tours, boat transportation, hiking, beach walking, guided or unguided kayaking, kayak rentals, orientation and instructional sessions or classes, transportation, accommodation, food and beverage, water supply, all other activities and services, use of facilities or equipment, and all travel by or movement around boats, floatplanes, helicopters, vans or other vehicles. 

    In consideration of the K’aayxada Adventure Camp providing to me Wilderness Activities, the receipt and sufficiency of which I acknowledge, I RELEASE AND FOREVER DISCHARGE K’aayxada Adventure Camp, and its affiliates, subsidiaries, directors, officers, employees, agents, guides, contractors, and shareholders (collectively, the “Releasee”) of and from any and all manner of actions, causes of action, loss, damage, expense, suits, contracts, claims, damages, and personal injury, of any nature or kind whatsoever, whether in law or in equity or pursuant to statute, which as against the Releasee or any of them I ever had, now have or at any time hereafter may have, arising out of my participating in Wilderness Activities. 

    I represent and warrant to the Releasee that I am in good health and physical condition and I am not taking medication or suffering from a condition that would make it potentially dangerous or harmful for me to participate in the Wilderness Activities. 

    I UNDERSTAND AND AGREE THAT: 

    1. TO WAIVE ANY AND ALL CLAIMS that I have or may in the future have against the RELEASEES AND TO RELEASE THE RELEASEES from any and all liability for any loss, damage, expense or injury, including death, that I may suffer or that my next of kin may suffer, as a result of my participation in the Wilderness Activities, DUE TO ANY CAUSE WHATSOEVER, INCLUDING NEGLIGENCE, BREACH OF CONTRACT, OR BREACH OF ANY STATUTORY OR OTHER DUTY OF CARE, INCLUDING ANY DUTY OF CARE OWED UNDER THE OCCUPIERS LIABILITY ACT, ON THE PART OF THE RELEASEES, AND FURTHER INCLUDING THE FAILURE ON THE PART OF THE RELEASEES TO SAFEGUARD OR PROTECT ME FROM THE RISKS, DANGERS AND HAZARDS OF PARTICIPATING IN THE WILDERNESS ACTIVITIES REFERRED TO ABOVE; 

    2. The areas used for the Wilderness Activities are uncontrolled, unmarked, and not inspected and my participation in the Wilderness Activities involves many risks, dangers and hazards, some of which are known and others of which are unknown, including, without limitation, adverse weather conditions, effects of boat movement, equipment failure, encounters with animals, impact or collision, or becoming lost or separated from my party or guide. 

    3. My participation in the Wilderness Activities may pose physical risk to me or damage to my property and I may suffer injury or loss, including, without limitation, soreness, temporary or permanent paralysis, drowning, hypothermia, or death. 

    4. Due to the nature of the Wilderness Activities, communication may be difficult or impossible and in the event of accident or illness, medical treatment or evacuation may be delayed or unavailable. 

    5. All expenses associated with non-scheduled or emergency evacuation, rescue or first aid will be my responsibility and will not be paid for by K’aayxada Adventure Camp or if so paid, I agree to repay K’aayxada Adventure Camp for such expenses. 

    K’aayxada Adventure Camp’s agreement to permit me to partake in Wilderness Activities is based on the strict understanding that I assume all of the risk involved in partaking in the Wilderness Activities and that the Releasee will not be held responsible in any way should I become injured or suffer any adverse consequences as set out in this Release Agreement, even if such injury or adverse consequence arises from the negligence or actions of the Releasee or others. I understand that negligence includes failure on the part of the Releasee to take reasonable steps to safeguard or protect me from the risks, dangers and hazards of the Wilderness Activities. 

    THIS IS A FULL RELEASE OF ALL CLAIMS. PLEASE READ IT CAREFULLY. 

    I acknowledge, as evidenced by my signature below, that I have carefully read, understand and agree to the foregoing prior to my participating in the Wilderness Activities and that K’aayxada Adventure Camp would not agree to permit me to partake in the Wilderness Activities if I did not agree to the terms set out above. 

  • Date of Signature*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Drug and Alcohol Use Policy

    This section must be completed by both the Student and a Parent/Guardian. Please read this section together.
  • The K’aayxada Adventure Camp Society and its programs aim to promote healthy lifestyles. Exercise, nutritious food and outdoor exploration are key components of all K’aayxada Adventure Camp programs. Since the effects of drug and/or alcohol use can lead to unsafe and unhealthy behaviours, K’aayxada Adventure Camp prohibits the use, distribution and presence of drugs and alcohol at its camp and during any of its programs.

  • PARTICIPANT AGREEMENT AND ACKNOWLEDGEMENT OF POLICY

    As a participant in a K’aayxada Adventure Camp program, I understand and acknowledge the above K’aayxada Adventure Camp Society Drug and Alcohol Use Policy. 

    Furthermore, I understand that the consequences of violating this policy include, but are not limited to: 

    1) my immediate removal from the program 

    2) my suspension from school and

    3) a report to police

  • Date of Signature*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Electronics Policy

    This section must be completed by both the Student and a Parent/Guardian. Please read this section together.
  • K’aayxada Adventure Camp is an electronics-free zone.  It is an opportunity for students and staff to take a break from their devices and connect with the place where they are, their peers, and themselves. As our world becomes increasingly oriented towards people being on their devices, opportunities like this become even more important.

    There are a few items that you should bring with you to camp to be prepared and comfortable without your device:

    • Flashlight: A flashlight is important for finding your way after dark. Either a handheld flashlight or a headlamp will work great.  
    • Books, Crafts, and Other Activities:  You may want something to do by yourself in your downtime or in the evenings before you go to sleep.  Consider bringing a good book that you want to read. Or some art or craft you are working on. Perhaps you want to knit something.  Bring something that engages and relaxes you. We also have many of these things at camp already.
    • Camera: You might want to take photos, which is great. Consider bringing a camera. Camp also has an amazing GoPro camera which you are welcome to borrow while at camp.

    Be aware that K'aayxada Adventure Camp staff will ask you to put your electronics away if they see them out at camp.

    This policy also includes the use of satelite texting on phones. 

  • Date of Signature*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Photo Release Form

    This section must be completed by both the Student and a Parent/Guardian. Please read this section together.
  • The K’aayxada Adventure Camp Society would like to use photographs and videos taken during their programs in marketing the camp through its website, videos, brochures, advertising, and social media.


    By signing this form, you give permission to the K’aayxada Adventure Camp Society to use any photographs of you and/or your child for use in marketing and promotion only.


    Thank you for your consideration; if you have any questions or concerns please contact the Executive Director at kaayxadaadventurecamp@gmail.com.

  • Date of Signature
     - -
    2 digit month, 2 digit day, 4 digit year
  • Date of Signature
     - -
    2 digit month, 2 digit day, 4 digit year
  • If you DO NOT give permission for you/your child’s photograph to be used, please print “I do not give permission for my photo/my child’s photo to be used by K’aayxada Adventure Camp,” in the field below, then sign your statement below. 

  • Image field 173
  • SCHOOL DISTRICT NO. 50 (HAIDA GWAII)BOARD POLICY MANUAL

  • POLICY 3500-2 HIGHER RISK FIELD TRIP PERMISSION FORM 

    Revised: Jan 2026

    April 2010

    September 2008

  • I have read and I am informed about the proposed field trip, K'aayxada Adventure Camp (name of trip) in Moresby Island (place of trip) on    Pick a Date*   Pick a Date* (dates).

    This permission form comes with a detailed itinerary, names of adult supervisors, pertinent phone numbers, and safety information. I have been invited to an informational meeting with all concerned to review all aspects of this field trip.

    I request that my child participate in this field trip. The ratio of students to adult supervisors is 6:1.

  • The following statement must be signed by the parent/guardian for students participating in Higher Risk Field Trips.

  • I am aware and understand that participation in the Higher Risk Field Trip described above involves certain inherent risks, dangers and hazards which may result in serious personal injury, or death or other loss or damage to property. I release and agree to indemnify and hold harmless the Board of Education of School District No. 50 (Haida Gwaii), its employees and its agents (the Releases), from any loss, claim or demand for any and all negligence arising as a result of the Student’s involvement or participation in the Higher Risk Field Trip except where such negligence is caused by the Releases.

    I understand and accept that the Board and its employees and agents may at anytime cancel the Higher Risk Field Trip for appropriate reasons including travel advisories. Accordingly I agree to waive any and all claims against the Board, its employees and agents for any monetary loss arising from the cancellation of the Higher Risk Field Trip.

    I understand that during the Higher Risk Field Trip the Student may incur additional unforeseen financial expenses required for reasons of safety and I agree to waive and reimburse for any and all claims against the Board, its employees and agents for any such expenses that are reasonably required.

  • Both my son/daughter and I understand that (school name) conduct policy as outlined in the school agenda applies on all field trips. Any prohibited behaviours such as physical or mental intimidation of staff or fellow students, outright defiance or illegal activities may result in suspension from school. Students engaging in these behaviours are liable to be sent home at their family’s expense.

  • Student Expectations

    1. Obey instructions/directions of the supervisor;
    2. Understand that it is a privilege to travel on behalf of the school and school district and, for disregard of travel rules, the privilege may be withdrawn;
    3. Conduct themselves in a manner that will bring credit to their parents/guardians, their supervisors, their school and the district;
    4. Return completed Parent Request Forms and travel fee in advance of the trip;
    5. Cooperate with their classroom teachers and staff and complete assignments;
    6. Ride on school arranged transportation, unless arrangements have been made with the supervisor and the principal prior to the travel;
    7. Be in the company of one or more “buddies” at all times;
    8. Assist in any clean-up at the activity site or during related activities;
    9. Obtain express permission of the supervisor prior to participation in any unscheduled/unplanned activity;
    10. Comply with criteria specific to the activity as outlined by the school and supervisor in the planning stages. I.e.: Attendance to school & associated meetings, curfews optional activities, access of funds, sportsmanlike conduct in practices and events;
    11. Attend school if it is in session, up until the time of departure and immediately upon return, unless excused by the supervisor.
    12. Each participating student shall have in their possession any necessary personal identification (photo id, student card, passport, etc.).
  • Further, the consumption of alcoholic beverages or the use of illegal substances will result in the immediate withdrawal of participation in the activity, and associated privileges to travel and the return home of the student as soon as convenient at the expense of the parent/guardian.

    If in the opinion of the supervisor and principal there are any other serious misconduct the student may be suspended and returned home at the expense of the parent/guardian including behaviours such as physical or mental intimidation.

  • I have read and understood the information above and request that my son/daughter be included in this activity.

  • Date*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Should be Empty: