The 2020 Camper Medical & Personal Form form is kept confidential.
Every camper needs a completed Medical & Personal Form to participate in any camp programs. Please fill out this form as completely as possible.
Thank you very much!
DAY CAMPER MEDICAL FORM
Section 1 - Basic Contact Information
Section 2 - Insurance Information
Section 3 - Medications
Section 4 - Allergies & Dietary Limitations
Section 5 - ImmunizationsCheck all that apply. If you do not know if the camper has had certain immunizations, leave blank.
Section 6 - Health HistoryPlease know that we repsect you and your camper's privacy. Health history information is ONLY avaliable to The Hollows Camp staff and any required emergency medical professionals. The more information you provide, the better we can do our job and ensure the safest experience at camp. Thanks!
DAY CAMPER PERSONAL FORM
We want to provide a happy, educational and safe summer camp experience for your child. In order to accomplish this, it is necessary to have as much information as possible about his or her habits, likes and dislikes.
Would you please give the following questions your careful attention, and thereby assist us in helping your child and you.
Note: Height and Weight information is only used to assit us in selecting an appropriate horse or pony for you child should they be riding.
Section 7 - Authorization & CONDITIONS OF ENROLLMENT
Applications may be cancelled with refund (less $100.00 + HST administrative costs) for medical reasons. The financial obligations of the camp are fixed and the withdrawal of a camper does not lessen operating expenses. I understand that all funds are non-refundable after June 1st 2020 under all circumstances.
To the best of my knowledge my child is in good health and is physically able to participate in camp activities. In case of emergency, I hereby give permission to The Hollows Camp Ltd. to secure medical treatment for my child.
I understand that this information is confidential, will not be disclosed and agree that it may be stored under secure conditions by The Hollows Camp.
I hereby absolve and release The Hollows Camp Ltd., their directors, officers, employees, instructors and agents from any and all claims for damages or injuries sustained by my child or myself resulting from any activities, training, race, or competition sponsored by or carried on by The Hollows Camp Ltd.
I hereby consent that The Hollows Camp Ltd may use my camper’s photo image.
I understand that this information is confidential and agree that it may be stored under secure conditions with the camp records. I agree that this information may be shared with my child’s counsellor on an “as needs” basis.
I understand that The Hollows Camp Ltd., has a zero tolerance policy for: bullying, verbal harassment, physical harassment, all forms of smoking/vaping, non-prescription drug use, alcohol consumption, vandalism, defamation of character, discrimination based on religion, race, cultural background, sexual orientation or disability. I understand that should myself or my camper(s) fail to adhere to the above terms the result will be an immediate dismissal from camp without refund.
I hereby indemnify, agree to defend, and hold The Hollows Camp Ltd. harmless from any and all loss, damage, or injury to any person or persons whosoever, or property, arising from any cause or reason whatsoever in or about The Hollows Camp Ltd. grounds or their described facilities; and further agree to waive all claims against The Hollows Camp Ltd., their employees, officers or directors on account of any loss, damage, or injury from whatever cause which may occur to it on its property in the use and occupancy of The Hollows Camp Ltd. premises; and I agree to promptly and upon demand, reimburse The Hollows Camp Ltd. for any damage done to the Camp premises or equipment, and for equipment lost or stolen by the above named camper.