This form should be filled out by the participant applying in the program and their parent/guardian. 

The Camp Director reserves the right to dismiss a camper who in his/her opinion is a hazard to the safety and rights of others, or who appears to have rejected the reasonable controls of the camp. The parent/guardian certifies that the applicant camper is normal in condition and habits and is amenable to necessary discipline. Failure to disclose problems at time of application could result in dismissal.

The parents/guardians submitting this form are those having legal custody over the child. Conditions of custody, if applicable, will be fully communicated in writing to the camp, including a photocopy of the section of any court order referring to visitation rights.

I, the parent or guardian of the named participant on this form, release T1D Kids Camps Inc., its trustees, directors, corporation members, staff and agents from any loss, personal injury, accident, misfortune or damage to the named participant on this form or his/her property, with the understanding that reasonable precautions shall be taken to ensure the health and safety of the named camper on this form.

Each camper must be covered by a Provincial Medicare or equivalent medical insurance. The signature or digital signature of the parent/guardian on the application shall give the Camp Director the right to arrange for any special services or other requirements necessary for the best interest of the camper and shall give the Camp Director the right to approve and obtain medical attention necessary for the camper’s welfare and good health including ordering injection, anaesthesia or surgery. In such situation the camp will attempt to notify the parents as soon as possible. The parents/guardians are responsible for any additional expense that may result from such services.

I agree that the information collected will only be used by T1D Kids Camps Inc. for the specific purpose of providing your child with a memorable camp experience. In order to do so, Camp Dragonfly may need to share sensitive information, to appropirate staff, volunteers, and medical personnel.

I have read this entire waiver and I accept the temrs, conditions and policies. 

For photographs and video images taken of my child during this program by T1D Kids Camps and/or our Site partners, I grant the following:

Copyright and/or use of photographic representations of my child in various forms of media used by photographers and computer artists to assist the Camp, including to use in publicity, promotion, camp advancement, marketing, and/or educational purposes including the use of any printed or multi-media materials.

I hereby realize and accept that my child is participating on a voluntary basis and will not receive financial remuneration from the photographer, the camps or any firm publishing and/or distributing the finished product.

Note on Tier Fee Structure: We understand that every family’s budget is different. We have developed a three-tiered pricing program to help cover costs for those who need financial support. Regardless of the amount paid, your child’s experience at camp will not change.

Even at tier one we will be subsidizing a portion of the camp's fee in order to make it accessible to all families affected by type 1 diabetes. Please choose the tier that best represents what your family can afford for a diabetes camps experience. We truly appreciate your support in helping us provide memorable camping experiences to children with type 1 diabetes in New Brunswick.

Payment terms and conditions 

• All payments are due no less than 3 weeks in advance of the program's starting date.
• More than 3 weeks before the program start date, all but $50 is fully refundable.
• Less than 3 weeks before program start date, no refunds will be isssued  unless written explanation from a doctor is received in which case, the deposit ($50) is the only non-refundable amount.
• Substitutes are not permitted.
• There is no refund once camp date starts, including dismissal for inappropriate behaviour. See "code of conduct" for more information.
• There are no fee adjustments if a guest arrives late or leaves early.
• We reserves the right to cancel the program due to a lack of participants and a full refund would be immited in this situation including the deposit ($50).