Saturday Camp Registration

COVID PROTOCOL

All Staff, Clients and Visitors must show proof of vaccination.

We are following all COVID protocols as outlined by Public Health.

Programs are open to participants who can be in our programs in safe and independent ways,

or who can brin a support worker for personal care and engagement.

Thank you for understanding.

 

 

Saturday Camp run from 9:00am to 3:00pm 

 

2021-2022 Saturday Camp Days

 

October 16th & 30th, 2021

November 13th & 27th, 2021

December 4th & 18th, 2021

January 8th & 22nd, 2022

February 5th & 19th, 2022

March 5th & 26th, 2022

April 9th & 23rd, 2022

May 14th & 28th, 2022

June 11th & 25th, 2022

 

 

 

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):

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*
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 Saturday Camp program.

 

Release and Indemnification

In consideration of Red Roof Retreat accepting within the application, I parent/guardian of Saturday Camp child agree to indemnify and hold harmless Red Roof Retreat 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 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.

Additional Comments

Security

Share This Form

Powered by eTapestry