Saturday Camp Registration

Please note that Red Roof Retreat cannot provide 1:1 support for any child. Typically the ratio of staff to children at Saturday Camp is 1:3. Red Roof Retreat has the right to accept or deny a registration at their discretion or to send a child home early due to health, medical or behavioural concerns.

 

Saturday Camp run from 9:00am to 4:00pm 

 

2019-2020 Saturday Camp Dates

October 5, 2019

October 19, 2019

November 2, 2019

November 16, 2019

December 7, 2019

December 21, 2019

January 11, 2020

January 25, 2020

February 8, 2020

February 22, 2020

March 7, 2020

March 21, 2020

April 4, 2020

April 18, 2020

May 2, 2020

May 16, 2020

June 6, 2020

June 20, 2020

 

After completing and submitting this registration form please wait for confirmation before choosing and paying for your childs Satuday Camp dates.

 

Immediately after completing this form please email a photo of your child to the Recreational Program Coordinator at recreation@redroofretreat.com

**YOUR REGISTRATION WILL NOT BE PROCESSED WITHOUT A PHOTO OF YOUR CHILD**

 

***Payment MUST be made by the Thursday at 4pm before the session you wish to register your child for. If this deadline is not met, you will not be able to register your child for that program date.

 

We are unable to issue refunds without adequate notice. Cancellations must be made by 4pm on the Thursday before your child’s scheduled program date.

Program Registering For (please check off):
  • Saturday Camp

Contact Information

Country*
Email*
Confirm Email*
Home Phone*
Mom's Cell Phone Number
Moms Work Phone Number
Dads Cell Phone Number
Dads Work Phone Number

Registration Form

Childs Name*
Date of Birth (DD/MM/YYYY)*
Age*
Health Card Number*
Doctors Name*
Doctors Phone Number*

Emergency Name & Contact Number (other than parents):

Emergency Contact Name (1)*
Emergency Contact Number (1)*
Emergency Contact Name (2)*
Emergency Contact Number (2)*
Person Responsible for dropping off*
Person responsible for picking up*

Health Information

Diagnosis*
Behavioural Concerns*
Allergies*
Medication*
  • My child does not take any medication
  • My child will not need medication during camp hours
  • My child will need medication at camp
Please list Medications, Dosage/Time, Route:*
Seizure Protocol

Waivers

By submitting this registration form you agree to:

 

I/we the parent(s)/guardian(s) are aware of this application and are in agreement with the above application requirements (ie. payment of fees and waivers to be signed). I/we are aware of the nature of Red Roof Retreat’s programs and give consent for my/our child to participate.

 

Photo/Video Release

I, consent to the use of any photos or videos taken of my child during Saturday Camp.

 

Oath of Confidentiality

To demonstrate respectfulness to others, I/we agree to keep confidential all information concerning other children/families being served by the Red Roof Retreat/Niagara Ina Grafton Saturday Camp program.

 

Release and Indemnification

In consideration of Red Roof Retreat/Niagara Ina Grafton Village accepting within the application, I parent/guardian of Saturday Camp child agree to indemnify and hold harmless Red Roof Retreat and the Niagara Ina Grafton Village, its servants, agents or employees and all other organizers, sponsors, representatives and any other person or organization assisting in this Saturday Camp program from any claims, demands, damages, actions or causes of actions arising out of or in consequence of any loss, injury or damage to my person or my property incurred while attending at or participating in the Saturday Camp, notwithstanding any such loss, injury or damage that may have risen by reason of the negligence of Red Roof Retreat and the Niagara Ina Grafton Village, its servants, agents or employees and all other organizers, sponsors, representatives and any other person or organization assisting in this Saturday Camp program, arising out of or in consequence of the attendance or participation by at the Saturday Camp operated by Red Roof Retreat and the Niagara Ina Grafton Village.

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