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PLAY
PLAN TRIP
GROUPS
EVENTS
- APAO GANG WARZ EVENT
- VENDORS
SUMMER CAMPS
SPECIALS
GIFT CARDS
STORE
FOOD
- DONUTS

Our commitment to play safely

SUMMER CAMPS

Adventure Summer Day Camps

**In order for your child to be registered and prepared for camp, you must reserve a spot, complete the registration form below, and fill out the waiver.

Summer Day Camp Registration Form

Event Dates:

July 8th - 12th

July 22nd - 26th

Camper's First Name:

Middle Name:

Last Name:

Camper's Cell:

Birthdate:

Camper's Age on July 1st:

Gender:

Male

Female

Shirt Size (please include Youth or Adult):

Mailing Address:

City/Town:

Province/State:

Postal Code/Zip:

Home Phone:

Email:

Camper's Health Card Number:

Version Code:

Free Text

Out-of-Canada campers: indicate any medical plan, numbers & billing address, (attach separate piece of paper if necessary)

Family Doctor Phone:

Address:

City:

Free Text

PARENTS / GUARDIANS:

Title:

Mr.

Mrs.

Ms.

Miss

Dr.

First & Last Name:

Relationship to Camper:

Cell/Pager:

Work/Alternate:

Free Text

PARENTS / GUARDIANS:

Title:

Mr.

Mrs.

Ms.

Miss

Dr.

First & Last Name:

Relationship to Camper:

Cell/Pager:

Work/Alternate:

Free Text

Alternate Pick Up Authorization: In the event that I/We are not able to pick up my/our child, he/she has my/our permission to leave with the following individual(s):

Name:

Phone:

Name:

Phone:

Notes:

Free Text

EMERGENCY CONTACTS: List in order who should be contacted in case of emergency if parents/guardians are not able to be reached first

1st Contact:

Mr.

Mrs.

Ms.

Miss

Dr.

First & Last Name:

Relationship

Home Phone:

Work Phone:

Cell Phone:

Cottage Phone:

Free Text

2nd Contact:

Mr.

Mrs.

Ms.

Miss

Dr.

First & Last Name:

Relationship:

Home Phone:

Work Phone:

Cell Phone:

Cottage Phone:

Free Text

ALLERGIES: Be specific. If camper uses an Epipen, they must bring it to camp. Indicate Type: Drug, Food, Environmental, Insect, Other Allergen.

Allergies:

Free Text

Type & Severity of Reaction (Indicate if life-threatening) Management / Treatment / Medication

Type...

Your Child's Swimming Ability:

ASTHMA: Does your child suffer from asthma?

Yes

If yes, indicate severity?

Mild

Moderate

Severe

What are the triggers for these Asthma attacks?

MEDICATIONS: Is camper currently on any medication (prescription or over the counter)? If so, what?

How and when is this medication administered?

ACTIVITIES: Does your child have any physical, health, developmental, behavioural, or emotional condition that may affect his/her ability to participate in camp activities? If yes, give details.

Free Text

***Parents will be responsible for any charges/expenses incurred to Marked Adventure Park if their child needs to be evacuated from an off-site trip, due to a medical or health condition that was not disclosed prior to their child’s attendance.

I understand that failure to disclose pertinent information that could impact the safety of my child, or the safety of other campers and staff, will result in the camper being sent home at the parent/guardian’s expense.

▪ To the best of my knowledge, my child is in good health. I will notify Marked Adventure Park if there is any change in my child’s health, or he/she is exposed to any communicable disease within 3 weeks prior to arrival at camp.

▪ In the case of medical emergency, I understand every effort will be made to contact parents or guardians. In the event I cannot

be reached, I hereby give permission to Marked Adventure Park to hospitalize, secure proper treatment, order injection, anesthesia or surgery for my child as named above.

▪ I will submit any changes to this health form in writing to the camp prior to arrival.

Campers can bring their own bag lunch & snacks. Please no foods containing peanut/nuts.

Lunches and snacks can be purchased at Marked Adventure Park.

Bug Spray and Sun Screen are HIGHLY recommended.

Thank you for submitting your registration form. We will contact you if there are any issues. Please don't forget to reserve a spot through our booking tool or completing the Marked Adventure Park Waiver Form.

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