Day Camps

Camper Information Form

Registration Details

Childs Name

Date of Birth

Select the Camp(s) you have registered for

Select the Week(s) you have registered for

Contact Information

1 Parent/Guardian Name

1 Parent/Guardian Number (Format 999-999-9999)

2 Parent/Guardian Name

2 Parent/Guardian Number (Format 999-999-9999)

Emergency Contact Name

Emergency Contact Number (Format 999-999-9999)

Is your child authorized to sign themselves in and out each day? We recommend children be at least 9 years old

NoYes

Is there someone other than the parent/legal guardians authorized to pick up your child? Please give their name and phone number

Name

Phone Number (Format 999-999-9999)

Medical Information
Please put "No" in each box if not applicable

Does your child have any allergies or medical concerns? Do they carry an epi-pen or require any other medications? Please note camp staff will not administer medication to campers. Please contact us if your child requires medication during camp hours.

If your child is having a hard moment at camp, is there any techniques you or your child already use to get back on track?

Does your child have a favorite game, craft, activity or book?

Is there anything else our staff should be aware of for your child's success at camp?

Disclaimer Authorization

I do hereby grant the Town of Canmore the right to use, without fee or payment, any photographs featuring my child for use in furthering youth programs and to promote sport in promotional materials, publications, posters, and advertising or on the internet. I hereby release on behalf of myself and my heirs, executors, representatives, successors and assigns, the Town of Canmore and its partners and suppliers from any recourse or claims which I may have now or hereafter resulting from any use of images featuring my children. I affirm that I am 18 years of age or older and I have read this release before signing below and I fully understand the contents, meaning, and impact of this release.

Photo Release Authorization

The Town of Canmore accepts no responsibility for persons who may contract COVID-19 or other infectious illness as a result of their use of these facilities. Please comply strictly with all public safety rules, guidelines, and policies.

Coronavirus Disclaimer

The personal information you provide on this form is being collected by the Town of Canmoreand Alberta Health Services under the authority of section 33(c) of Alberta’s Freedom of Information and Protection of Privacy Act. This information will be used to administer programming during the covid-19 pandemic for Town of Canmore Recreation Day Camps. Your personal information is protected by the privacy provisions of the Freedom of Information and Protection of Privacy Act. If you have any questions about the collection, use, or disclosure of this information please contact the Child & Youth Coordinator at 403-679-5006, or 1900 8th Ave, Canmore, AB, T1W 1Y2.

FOIP Notification

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