2026 GUARDIANS OF THE PARKS SUMMER AGES 10

Guardians of the Park Summer Camp

Ages: 10 - 12 | Dates: July 28 - 31 | Location: Pembina Nordic Centre
Participants Personal Information
Participant's Name*

First NameLast Name
Participant's age at start of camp*
Participant's date of birth*

MonthDayYear
Date
Parent/Guardian Information
1st Parent/Guardian Name*

First NameLast Name
1st Parent/Guardian Email*
example@example.com
1st Parent/Guardian Home Phone*
Please enter a valid phone number.Format: (000) 000-0000.
1st Parent/Guardian Cell Phone*
Please enter a valid phone number.Format: (000) 000-0000.
1st Parent/Guardian Work Phone*
Please enter a valid phone number.Format: (000) 000-0000.
2nd Parent/Guardian Name*

First NameLast Name
2nd Parent/Guardian Home Phone*
Please enter a valid phone number.Format: (000) 000-0000.
2nd Parent/Guardian Cell Phone*
Please enter a valid phone number.Format: (000) 000-0000.
2nd Parent/Guardian Work Phone*
Please enter a valid phone number.Format: (000) 000-0000.
Both Parents/Guardians1st Parent/Guardian2nd Parent/Guardian
Both Parents/Guardians1st Parent/Guardian2nd Parent/Guardian
Authorized Pick Up Contacts (Adults Only)

Please list the full name and phone number of any adult (18+) authorized to pick up your child from camp. Only individuals listed here will be permitted to pick up your child.
1st Authorized Pick Up Contact Name

First NameLast Name
Authorized Pick Up Contact Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Relationship to Participant?
2nd Authorized Pick Up Contact Name

First NameLast Name
Authorized Pick Up Contact Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Relationship to Participant?
Alternate Emergency Contact Information

A person over the age of 16 who is authorized to pick up your child and can be contacted by EPBR Parks Council staff if the parent/guardian can not be reached.
1st Alternate Emergency Contact Name*

First NameLast Name
Emergency Contact Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Relationship to Participant?*
YesNo
2nd Alternate Emergency Contact Name*

First NameLast Name
Emergency Contact Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Relationship to Participant?*
YesNo
Participant Health History and Personal Information

The more information you can provide, the better we can be at meeting your child’s needs. This information will be treated with confidence.
YesNo
YesNo
Please indicate any medical conditions below:
YesNo
Please indicate any allergies below:
YesNo
Please indicate any medication to be administered:
YesNo
Please provide a description below:
YesNo
Please indicate any behavioral conditions below:
YesNo
YesNo
Please indicate any dietary restrictions below:
I agree and understand
Please indicate any other details you wish to share about the participant below:
Participant Code of Conduct

The safety of all of our participant is of utmost importance to EPBR Parks Council. Each participant must take responsibility to learn and follow all of our safety guidelines and rules while attending our day camps. If a participant's behavior puts themselves or other participant's safety at risk, we may require that the participant is dismissed from camp.
Please review the Participant Code of Conduct for the Gaurdians of the Park Summer Day Camp 2026 here:

https://www.epbrparkscouncil.org/?attachment_id=4862
I have read and understand the Participant Code of Conduct
Refund Policy
At Eagle Point-Blue Rapids Parks Council, we strive to provide the best experience for our participants. However, we understand that sometimes plans change. To ensure fairness and transparency, we have outlined our refund policy below:

Refund Request Deadline:
- Participants may request a refund up to July 14, 2026.
- Refund requests made on or before this date will be processed, minus a $15.00 administrative fee. This fee will be deducted from the refund amount.
  Non-Refundable After Deadline:
- Refund requests made after July 14, 2026, will not be honored.
  No exceptions will be made to this policy.
How to Request a Refund:
- To request a refund, please contact us at finance@epbrparkscouncil.org with your registration details.
- Refunds will be processed within 3 business days from the date of the request.
Changes and Cancellations by the Eagle Point-Blue Rapids Parks Council
- In the unlikely event that Eagle Point-Blue Rapids Parks Council needs to cancel or significantly alter the event, participants will be notified as soon as possible.
- Participants will be offered the choice of a full refund or transfer of registration to a future event.
We appreciate your understanding and cooperation. If you have any questions or need further assistance, please do not hesitate to contact us.
I have read the Refund Policy and understand
Authorization
Program: Guardians of the Parks Summer Day Camp 2026
Parent/Guardian:   First Name*   Last Name*
Participant (your child):   First Name*   Last Name*
Organization: Eagle Point - Blue Rapids Parks Council
Location: P

By registering the Participant (your child) for Guardians of the Parks Summer Day Camp, hosted by Eagle Point-Blue Rapids Parks Council, I give permission for the participant to participate in a full range of camp activities including off-site activities. While camp staff make every reasonable effort to ensure that the participant is safe and that risks are minimized, I authorize Camp Facilitators and their appointees, in the event of an accident or illness affecting the participant, to authorize on my behalf all procedures including admission to hospital and necessary treatment deemed essential for the care and well being of my child.

I have read this Agreement and understand that it contains a promise not to sue the Parks Council or the Agents and that it constitutes a release of liability and an indemnity for all claims

This Agreement will be binding on myself, as the case may be, and our respective representatives, heirs and assigns.

Date*   Parent/Guardian Signature*
Photo & Video Release Permission
Record, photograph and tape (audio, video, still) my child, display images of my child, on the EPBRPC website/Facebook page/Instagram page, and display images of my child publicly (open houses/promotional materials /funders etc.).I do not wish to have any images or photos taken of my child.
I have read and understand the Refund Policy
By providing my email, I am granting Eagle Point-Blue Rapids Parks Council permission to send me promotional and informational emails. These emails may include but are not limited to newsletters, special offers, and event invitations. I understand that if I no longer wish to receive these emails, I can unsubscribe at any time by clicking the "Unsubscribe" link at the bottom of any email I receive.*

I understand
My Products*
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Guardians of the Park Summer Day Camp 2026
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Guardians of the Park Summer Camp

Participants Personal Information

Parent/Guardian Information

Authorized Pick Up Contacts (Adults Only)

Alternate Emergency Contact Information

Participant Health History and Personal Information

Participant Code of Conduct

Refund Policy

Authorization

Photo & Video Release Permission