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Registration Form 2024


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Child's Gender
As the parent or guardian of the above-named child (“My Child”), I am aware that attending the Elizabeth Fry Society of Greater Vancouver Blue Sky Day Camp Program (the “Camp”) involves many risks and dangers. I understand that known and unknown risks and dangers associated with My Childs participation in this Camp may result in personal injury, death, property damage or loss. I understand as well that personal injury, death, property damage or loss may be caused or contributed to by the negligence or carelessness of others.

In consideration of the Elizabeth Fry Society of Greater Vancouver allowing My Childs participation in the Camp I agree, on behalf of MY Child, My Child’s next of kin, myself, my heirs, agents, assigns, personal representatives and next of kin, that:

1. I ASSUME, ON BEHALF OF MYSELF AND MY CHILD, WHITHOUT LIMITATION, ALL RISKS AND DANGERS associated with My Childs presence at and participation in the Camp.

2. I ASSUME FULL RESPONSIBILITY for ensuring that My Child understands the rules and safe practices associated with the Camp and any Camp activities, and for My Child’s personal safety.

3. I WAIVE ANY AND ALL CLAIMS ON BEHALF OF MYSELF AND MY CHILD against the Camp, the Elizabeth Fry Society of Greater Vancouver and its directors, officers, employees, agents and representatives (all of whom are collectively referred to elsewhere in this document as the “Camp”) arising from or connected with, directly or indirectly, My Child’s presence at the Camp or participation in any activity associated with the Camp.

4. I RELEASE the Camp, on behalf of myself and My Child, from any and all liability for any loss, damage, injury or expense that I, My Child, or My Child’s next of kin, may suffer or incur, due to any cause whatsoever, by reason of My Child’s presence at the Camp or participation in any Camp activity, INCLUDING NEGLIGENCE ON THE PART OF THE CAMP, OTHER PARTICIPANTS OR ANYONE ELSE.

5. I WILL INDEMNIFY AND HOLD HARMLESS the Camp from any and all liability for loss, damage, injury or expense incurred by myself, My Child, or anyone else in connection with My Child’s presence at the Camp or participation in any Camp activities.

I HAVE READ THIS DOCUMENT THOROUGHLY.

I UNDERSTAND THAT, BY SIGNING THIS DOCUMENT, I GIVE UP IMPORTANT LEGAL RIGHTS, INCLUDING THE RIGHT TO SUE ON MY CHILD’S BEHALF OR IN MY PERSONAL CAPACITY.

I UNDERSTAND THAT THE CAMP IS RELYING ON MY FULL RELEASE AND WAIVER OF ALL CLAIMS IN ACCEPTING MY CHILD’S PARTICIPATION IN THE CAMP.

Permission Slip: Give permission for them to attend the Blue Sky Day Camp in Surrey operated by the Elizabeth Fry Society of Greater Vancouver during session (only one week of camp per child)
Please check above which session you would like your child to attend
Has the child been affected by their birth family’s involvement in the Criminal Justice System?
Birth family member involved in the Criminal Justice System
Parent/Guardian/Emergency Contact 1: Name
Parent/Guardian/Emergency Contact 2: Name
Child lives with:
Legal Guardianship/Custody:
Alternate Pick-Up Authorization 1: Name
In the event that I/We have to pick up my/our child from Summer Camp, they have our permission to leave with the following individual(s)
In the event that I/We have to pick up my/our child from Summer Camp, they have our permission to leave with the following individual(s)
Alternate Pick-Up Authorization 2: Name
In the event that I/We have to pick up my/our child from Summer Camp, they have our permission to leave with the following individual(s)
In the event that I/We have to pick up my/our child from Summer Camp, they have our permission to leave with the following individual(s)
Photo Release
Dietary Information
Asthma: Does your child suffer from Asthma?
Asthma: If Yes, indicate severity:
Asthma: Does your child carry an inhaler?
Level of Swimming
Medications: Is your child currently on any medication (prescribed or homeopathic)?
Please confirm if the medication will need to be administered at camp
Health History: Please Check (√) if your child has had any of the following:
Recent Health Concerns: Has the child experienced any recent hospitalizations, operations, serious illnesses/injuries or infectious diseases?
By signing below, I attest to the truthfulness of all information listed on this health form and agree to all the above terms and conditions. I also acknowledge that I will notify the camp if there are any changes to my child’s health, or if he/she is exposed to any communicable diseases.
By signing above, I attest to the truthfulness of all information listed on this registration form and agree to all the above terms and conditions.