Summer Camp 2026 Registration Form

Carberry Summer Camp Registration

At the Carberry Rink
Camp Runs Weekly July 6th - August 28th from 8:00-4:30 PM
Camper Information
Camper's Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
**All campers must be 5 years old by July 1st, 2026, to attend camp**
What is the age of the camper?
ex: 5 years old
Camper's Cell Phone (if applicable)
Please enter a valid phone number.Format: (000) 000-0000.
Parent/Guardian Information
Parent/Guardian Contact Information

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Parent / Guardian Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Emergency Contact Information

First NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Our day camp is committed to creating a safe and inclusive enviroment for all campers. While we are unable to provide one-on-one support for children who require additional assistance, they are welcome to attend with their own dedicated support person.

If you have any questions or concerns please contact us @ 204-834-6623 or rec@townofcarberry.ca
Medical/Physical Conditions that may affect the campers participation, ie: Asthma, Diabetes, Anaphylaxis, Allergies etc.
Please give detailed medical information:
Is there anything important you feel we should know about your camper to help them have a success day/week at camp?
Injury Waiver

Recreational activity programs, such as the use of exercise equipment, involve a certain element of risk. Injuries may occur while participating in these activities. The following are examples of the types of injury which may result from participation in the above activity. There may also be a risk of other types of injury.

1. Scrapes, cuts, bruises

2. Strains, sprains, pulled muscles or ligaments

3. Possible fractures or broken bones (arms, legs etc.)

The risk of sustaining injuries can occur without fault of either the child, the Town of Carberry or the Municipality of North Cypress Langford, its employees, agents or the facility. By choosing to have your child take part in this activity, you are accepting the risk that your child may be injured. If you choose to have your child participate in the above-described activity, you must understand that you bear the responsibility for any injury that might occur. The Town of Carberry, the Municipality of North Cypress Langford does not provide accidental death, disability, dismemberment or medical expense insurance on behalf of the children participating in this activity.
ACKNOWLEDGEMENT:

I/WE HAVE READ THE ABOVE NOTICE. WE UNDERSTAND THAT IN PARTICIPATING IN THE ACTIVITY DESCRIBED ABOVE, WE ARE ASSUMING THE RISKS ASSOCIATED WITH DOING SO.
Date

MonthDayYear
Date
Signature
Payment

Cash, debit, or credit card payments are accepted at the Carberry Town Office (44 Main Street)

OR

E-transfer payments to rec@townofcarberry.ca

Please put the follwoing information in the memo line

"Summer Camp Your Child's Name"
Choose your Camp Adventures

EARLY BIRD PRICING APRIL 1-31ST $150/WEEK $30/DAY
Barnyard Palooza (July 6th - 10)
Superhero Academy (July 13th - 17th)
Nature Explorers (July 20th - 24th)
All Star Sports! (July 27th - 31st)
Splish! Splash! Water fun! (August 4th - 7th) * this is a 4 day week, only $125.00**
Ahoy! Pirates! (August 10th - 14th)
Our Community - Amazing Race Edition (August 17th - 21st)
ART-Ventures! (August 24th - 28th)
Pick a Day!

$30 per day (This is for campers who cannot come the whole week)
Barnyard Palooza
Superhero Academy
Nature Explorers
All Star Sports
Splish! Splash! Water Fun!
Ahoy! Pirates!
Our Community - The Amazing Race Edition
ART-Ventures Camp
Should be Empty:

Carberry Summer Camp Registration

Camp Runs Weekly July 6th - August 28th from 8:00-4:30 PM

Camper Information

Parent/Guardian Information

Choose your Camp Adventures

Pick a Day!