CPSC 2026 Camper Registration Form

Chapel Place Sports Camp Information:

WHEN: July 6th-31st

TIME: 9:30am-3:30pm (Extended care: 8am-5pm)

COST: $140 for regular hours (9:30am-3:30pm)

$170 for extended care hours (8am-5pm)

Early Registration Payment accepted via e-transfer: To be announced

WHERE: Buttonville Public School (141 John Button Blvd. Markham, L3R 9C2)

Please fill this form for each camper (born 2012-2020)

Camper Name

First NameLast Name

Gender

Birthday

Date

Grade completed June 2026

Age as of December 31, 2026

T-Shirt Size

child=youth

***Please note that t-shirts are not guaranteed to campers if registered after May 31, 2026

I want to buy extra T-shirts ($10 each)

Quantity of extra T-shirts (not guaranteed)

How did you hear about CPSC?

Other

Name of School

Name of Church (if you currently attend a church)

Please note, church affiliation is not required for camp registration

Please indicate which weeks you would like to register your child by selecting "yes" or "no" under the week of choice. Please note that the full payment must be received to secure your registration.

Registration fee for each camper, per week is as follows:

Regular Hours (9:30am-3:30pm) - $140/week

Extended Care Hours (8:00am-5:00pm) - $170/week (limited spots available)

Feel free to contact info@cpsportscamp.com should you have any questions or concerns.

Which hours would you like to register for?

Would you like to register for Week 1? (July 6-10) Soccer

Waitlist for Week 1:

Would you like to register for Week 2? (July 13-17) Basketball

Waitlist for Week 2:

Would you like to register for Week 3? (July 20-24) Multisport

Waitlist for Week 3:

Would you like to register for Week 4? (July 27-31) Day Camp (Carnival on last day)

Waitlist for Week 4:

*Please note: Weekly Activities/Themes (ie. Multi-Sport/basketball) are subject to change

The following information is being gathered for the sole purpose of best serving your child/ren during camp and will be kept confidential.

Any medical information collected here serves to authorize CPSC, its staff and volunteers, to obtain medical assistance in emergencies.

Health Card Number

Doctor Name

Doctor Phone Number

Area CodePhone Number

Does the camper have any allergies?

Please provide list of allergies

Is the camper bringing any medication with him/her? Do they require any medical treatment?

Please provide a list of medications or medical treatments

Does the camper have any physical, emotional, mental, or behavioural concerns that staff should be aware of?

Please specify any concerns

Parent/Guardian Full Name

First NameLast Name

Email

Cell Phone Number

Format: (000) 000-0000.

Home Address

Street Address

Street Address Line 2

CityProvince

Postal Code

Emergency Contact Name

First NameLast Name

Emergency Contact Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Please indicate supervision of transportation to and from camp:

Who are the friends/relatives who are able to sign in/out your children? (please include your name too)

List the names of children attending camp from your household

List the name(s) of the camper you are requesting to be with your child (same age, no guarantees)

Please indicate below whether you grant CPSC permission to use pictures/video containing your child in any or all of the following ways:

- Camp Website

- Promotional material

- Social Media

- Newsletter

- Finale Video

I grant permission

Are you interested in making a donation to Chapel Place Sports Camp? (ie. either as an individual or as a business)

I, the parent/guardian of:

1. Coronavirus/COVID-19/Other Contagious Disease: I acknowledge that my child is at increased risk of exposure to the Coronavirus/COVID-19. I acknowledge that The Church on the Everlasting Rock cannot guarantee that my child will not become infected with Coronavirus/COVID-19 or any other infectious disease. I further acknowlege that my child must comply with all set procedures to reduce the spread while attending their activities. I confirm that I will not be sending my child if they are experiencing any flu-like symptoms, have been diagnosed, or if they have been exposed to someone with a suspected and/or confirmed case of Coronavirus/COVID-19. I understand that if my child is ill or has a contagious disease, we will request that he/she be picked up and remain at home until fully recovered.

2. Release of Liability: I waive on behalf of myself and child any and all claims that I have or may in the future have against Church on the Everlasting Rock and CPSC Staff for any and all claims, demands, or actions including while at Church on the Everlasting Rock or out on field trips, tournaments, or competitions as a result of participation in the activites and the use of the premises and facilities due to any cause whatsoever.

3. Medical Release: In the event that I cannot be reached in an emergency, I hereby give permission to the physician selected by CPSC Staff to secure proper treatment for the child named above.

4. I authorize only the above named EMERGENCY/RELEASE CONTACTS, in addition to myself, to pick up my children from CPSC, or act as an authority in the event of an emergency if I cannot be reached.

5. I understand that my child may be sent home in the event that they do not abide by the rules.

I have read and agreed to the above waivers and conditions

Name

Date

Hour MinutesAM/PM Option

Chapel Place Sports Camp Registration Form

Camper Information

Registration Fees & Dates

Medical Information & Permission Statement