CONDITIONS OF ENROLMENT

A) Parent: I hereby acknowledge that in order to register my child for Camp, I must also complete the Camper Medical Form

provided by the Camp. This form will be filed as "private and confidential" by the Camp Nurse or First Aid Attendant. I also

understand that I must review the Camper Policies and Procedures with my child BEFORE signing this Registration Form.

The Camper Policies and Procedures are available on our website www.ebcfergus.org.

I understand and agree with these conditions and Camp Policies.

I give permission for EBC to use photos or videos my child is in for promotional material, and allow them to post photos in an online camp album that other parents/guardians/ebc staff members will have log-in information to.

Yes

Medical Information

OR If you have no provincial health coverage

Parent/Guardian to be contacted in the event of an emergency

In the event that the Parent/Guardian cannot be contacted, please notify:

Please indicate if your child is fully immunized for their age as outlined by the Province of Ontario. If you reside outside Ontario, please indicate if your child is fully vaccinated to the standards of that jurisdiction.

Yes

If no, then

NEW CAMPERS: Please provide one of the following documents to evangelical_baptist_camp@yahoo.com

A notarized Ministry of Education approved Statement of Conscience or Religious Belief form
Ministry of Education approved Statement of Medical Exemption form (completed by a doctor or nurse practinioner)
If you do not have those forms, you may fill out the EBC Written Immunization Exemption Form.

RETURNING CAMPERS: Your previously provided documentation will be forwarded to the current year.

Please answer the following questions:

Is there any condition in your family history or is there a past illness which might affect participation in this Camp?

Is there any medical condition for which the camper requires special medication, diet or regime? (ie. Allergies, Diabetes …) All Prescription Medication must be given to the Camp Nurse in the original labelled container as given by the pharmacy.

Are there any serious allergies requiring immediate attention? (ie. Insect bites, Penicillin, Peanuts …)

Are your vaccinations up to date?

Please provide the date of your last tetanus shot.

Please provide the date of your last complete physical and doctor's name and phone # if different than above.

Please note any information that might be helpful to the Camp Nurse or Head Cook.

AUTHORIZATION FOR TREATMENT

To the best of my knowledge, my child is (or if over 18, I am) in good health. I will notify the Camp if my child is (or if over 18, I am) exposed to an infectious or communicable disease during the three weeks prior to arriving at Camp. I hereby authorize the Camp personnel to handle any medical problems with my child (or if over 18, with me) during his/her/my stay at Camp. In the case of an emergency, after reasonable effort has been made to contact the Parent/Guardian, permission is hereby given to the Physician selected by the Camp to hospitalize, secure proper treatment, order injections, anesthesia or surgery for my child ( or if over 18, for me) as named above. This may include being off the Camp site overnight. I also agree to check in and out with the Camp Nurse or First Aid Attendant at the beginning and end of Camp. In signing this form, I recognize that there are inherent risks involved in some Camp activities and that I will assume full responsibility for myself, my actions, my property and for minors less than 18 years of age under my care while at EBC.

Please print name in place of signature. Parents will be asked to sign the form at registration

Please remember to bring your Health Card / Copy of Insurance on Registration Day

Please remember to bring your Health Card / Copy of Insurance on Registration Day.
All rates include accident insurance.
All rates include daily canteen.
Camp Registration Starts: Saturday July 20th at 2:00 PM
Camp Ends: Saturday July 27th at 11:00 AM SHARP.
Please ensure that your child(ren) is/are picked up on time. Please notify us if you have arranged for someone else to pick up your child(ren).