Camper’s Name (first & last):

Date of Birth:

Gender:

Parent/Guardian Names:

Address:

Daytime Phone Number:

Cell Phone:

Email Address:

Allergies or other relevant medical information:

Alternate Emergency Contact

Name:

Relationship to Camper:

Daytime Phone Number:

Cell Phone:

Email Address:

Dear Parents,
We are excited that your child has chosen to be part of our Adventurers Day Camp program. As part of the history experience, the children are given a costume to wear for the duration of the camp. These costumes are true to pieces that would have been worn by children in the 1850s. We understand that the children are having fun at camp and are by nature active, but we would appreciate it if you could tell your child that these costumes are on loan and due diligence must be taken.
Day Camp staff launders all costume pieces at the end of each week, but costumes can be washed throughout the week if necessary. Washing instructions:

• Whites and dark colors must be washed separately in warm water
• No bleach, please
• Do not dry in a hot dryer
• Ironing can be done but is not necessary

The complete costume must be left with the day camp coordinators on the last day of camp. Costs for replacing missing or damaged costume pieces are the responsibility of the parents and may be up to $500. Please be responsible.

I agree to and accept the above terms and conditions:

Parents signature

Child’s Name

Date

During your child’s attendance at the Company of Adventures Day Camp, there may be times where they will have the opportunity to have their photograph taken. A group photo will be taken each week. In addition, photos may be used for advertisements or other endeavors associated with the Friends of Lower Fort Garry. Please check one of the following below.

Child Name

I give permission for my child to have their photograph taken while at Lower Fort GarryI do not give permission for my child to have their photograph used for any other purpose than the weekly group photo

Parents signature

Child’s Name

Date

I understand as a parent / guardian of a child who is a participant in the Adventurers Day Camp run by the Friends of Lower Fort Garry at Lower Fort Garry National Historic Site of Canada (LFG), my child will participate in activities on the grounds of LFG. I agree that the choice to participate brings with it the assumption of those risks and results that are part of these activities. I agree that the Adventurers Day Camp, its trustees, officers, directors, employees, agents and independent contractors, shall not be liable for any injury to my child or any loss / damage to my child’s personal property arising from, or in any way resulting from, my child’s participation in these activities.

I authorize the Adventurers Day Camp to administer first aid to my child and to secure medical care for my child in an emergency as deemed appropriate by the attending physician(s). I certify that the information provided in my child’s registration form is, to my knowledge, true and complete.

I have read and understood the above waiver and consent and confirm that I am the parent or legal guardian of the child mentioned herein who is a minor. I confirm that I have the complete custody, care and control of the minor and have the legal authority to sign this consent and waiver on behalf of the minor and that the consent of no other person or entity is required.

Print Name of Parent / Legal Guardian

Signature of Parent/Legal Guardian

Date

Payment Options
Select payment type (required)Regular - $210 - Paypal

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