Camper Name
*
Date of Birth
*
-
Month
-
Day
Year
Date
Grade
*
Please Select
--Preschool
-Kindergarten
Grade 1
Grade 2
Grade 3
Grade 4
Grade 5
Grade 6
Current Grade 2021-2022
Preschool Requirements
*
My child will be at least 4 years old when attending the camp.
My child is fully potty trained and can independently go to the washroom. I understand they will not receive assistance to go to the washroom.
My child is able to attend a full day without napping.
Parent 1 Name
*
Parent 1 E-mail
*
Parent 1 Phone
*
Parent 2 Name
Parent 2 Email
Parent 2 Phone
Emergency Contact
Backup contact info. Parents will be contacted first.
Allergies
Special Needs
Does your child have any special needs or disabilities?
Week 1
July 11-15, 2022 ($160)
Week 2
July 18-22, 2022 ($160)
Week 3
July 25-29, 2022 ($160)
Week 3
July 25-29, 2022 ($160)
Week 4
August 2-5, 2022 ($130)
Week 5
August 8-12, 2022 ($160)
Week 6
August 15-19, 2022 ($160)
Week 7
August 22-26, 2022 ($160)
Payment Amount
CAD
Third Sibling
Apply discount for third sibling
Parent Consent
*
I, as the parent or guardian of the above named child, shall not have any claim for compensation or damages of any kind as a result of my child participating in the LEAF Summer Camp. I provide consent for my child to be transported by bus, private vehicle, or walking to and from various locations for field trips, recesses, or other activities. I expressly waive any claim for damages of any kind for personal injury or other loss related to incidents, motor vehicle collisions, or illness against St. Mary and St. Mark Coptic Orthodox Church in Edmonton, its staff, trustees, or volunteers.
I consent to keep my child home if he/she has flu or COVID symptoms.
I understand that there will be Orthodox Christian faith-based concepts taught at the camp and that students will attend liturgy once a week (communion for those baptized in the Coptic Orthodox Church and sister Orthodox Churches).
I authorize LEAF Summer Camp to take photos or videos of my child to share experiences and memories with parents.
E-Signature
*
Comments
Payment
*
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