2026 Camp Kretinga Registration Form

First Name*

Last Name*

MaleFemale

YesNo

Arriving with parent/guardianArriving with the Calgary groupArriving with the Edmonton groupOther

Yes – camper will arrive on the first day and attend the full sessionNo – camper will arrive lateNo – camper will leave earlyNo – camper will arrive late AND leave earlyOther

FluentlyUnderstandsNot at all

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Birth Date*

MonthDayYear

Age at Camp*

Grade entering in the fall*

Cabin Buddy #1

Cabin Buddy #2

Mother's Name

Father's Name

MotherFatherBothOther

Emergency Contact #1 Name and relationship to camper*

Name & Relationship to camper

Emergency Contact # 1 Phone Number*

Emerg Contact Area CodeEmerg Contact Phone Number

Emergency Contact #2 Name and relationship to camper*

Name & Relationship to camper

Emergency Contact # 2 Phone Number*

Emerg Contact Area CodeEmerg Contact Phone Number

Parents Email (camper confirmation will be sent by email)*

example@example.com

Camper's Email

example@example.com

OHIP Number:

Insurance Company Name:

Insurance Policy/Group Numbers:

YesNo

Please upload a picture or document showing childhood immunizations are up to date:

Browse Files

YesNo

Please explain*

YesNo

Please explain*

YesNo

Please explain exact cause of allergy and reaction

Any dietary needs that we should know about?

YesNo

Please list each medication, the dosage and the times it should be taken.

Paid directly by parent/guardianPaid directly by another organizationParent/guardian is working at camp

Fees for all Campers ($)*

Donation ($)

Total ($)*

Cheque (made payable to Kretinga Inc., mail to Kretinga, 1 Resurrection Rd, Toronto, Ont, M9A 5G1)E-Transfer (E-Mail: Kretinga.Board@gmail.com, Question: Name of camp, Answer: Kretinga)

By clicking submit and entering your initials, you are confirming that you understand and agree to the following:

1. My child(ren) is/are in good physical and emotional health and amenable to normal camp authority and discipline;

2. I am legally responsible for the payment of fees and any other expenses incurred by my child(ren);

3. All the information provided on both pages of this form is true and complete in all respects;

4. The camp staff at their sole and exclusive discretion may terminate the stay of my child(ren) and I am responsible for the immediate removal of my child(ren) from the camp grounds upon notification of such termination;

5. In the case of an accident, neither I nor any other rights holder will hold the camp staff, administrators, counselors, or the campground owners accountable or liable in any respect;

6. I give my permission for a camp caregiver to give over the counter medications if my child is not feeling well;

7. I give my permission for my child(ren) to leave camp grounds for supervised swimming and supervised outings.

8. In the case of an emergency, I give permission for any medical procedures deemed necessary by an attending caregiver; and

9. I give permission to allow photographs/video to be taken of my child(ren) and to have them appear on the internet and on the distributed camp video.

10. I give my permission for a camp caregiver to administer a Covid-19 Rapid test to my child in the event they are exposed to the virus or have symptoms of Covid-19;

11. In the event that my child tests positive for Covid-19 while at camp, I understand that I will have to pick them up within 12 hours.

Electronic signature, please initial*

Camp Kretinga

Camper Name

Which Camp is Camper Attending ?

Travel & Arrival Information

Arrival & Departure Schedule

Camper's Information

Cabin Buddy

Parent Information & Emergency Contact

Email Confirmation

Health Information

Insurance Company

Immunizations

General Health Information

Allergies & Dietary Needs

Medications

2026 Registration Fees & Payment Responsibility

*If registering for the second week separately or after camp begins the additional week is $750

Release