2025 Summer Adventure Day Camps Registration Form

2025 Summer Adventure Day camps registration form

MEMBER INFORMATION

Child's Full Name (First/Middle/Last) *

First

Middle

Last

Child's Birthday *

Mailing Address *

Address Line 1

City

State / Province / Region

Postal Code

Physical Address (if different):

Address Line 1

City

State / Province / Region

Postal Code

School: *

Grade: *

Siblings Who Are Members:

Is this child in Foster Care? *

Background Information (Voluntary): To support BGC Battlefords in tracking statistics and applying for funding, please check if any of the below categories apply to your child:

Country of Origin:

PARENT/GUARDIAN INFORMATION

Parent/Guardian #1 Name: *

First

Last

Relation to Member: *

Cell Number: *

Alternate Phone Number:

Email Address: *

Employer:

Parent/Guardian #2 Name:

First

Last

Relation to Member:

Cell Number:

Alternate Phone Number:

Email Address:

Employer:

EMERGENCY CONTACT INFORMATION

*Will be contacted only if we're NOT able to reach the parents/guardians listed above*

Emergency Contact #1 Name (OTHER THAN the parents/guardians listed above. Ex: grandparent, family friend, co-worker, neighbour, etc.): *

First

Last

Relation to Member: *

Cell Number: *

City of Residence: *

Emergency Contact #2 Name (OTHER THAN the parents/guardians listed above. Ex: grandparent, family friend, co-worker, neighbour, etc.): *

First

Last

Relation to Member: *

Cell Number: *

City of Residence: *

MEDICAL INFORMATION

Does your child have any of the following? If yes, please provide details. If not, please mark “N/A.”.

If your child requires any medications (for allergies, medical conditions, etc.) while attending, separate medical/permission forms will be required. Forms are available online at www.bgcbattlefords.ca or in person (by visiting the office).

Allergies: *

Medical Condition(s): *

Learning/Behavioral Needs: *

Does your child have a disability? *

(e.g.: Physical Disability or Cognitive Disability such as: ADHD, FASD, etc.)

Other Considerations (Any additional information which may assist your child in positively participating in our programs.):

CONTRACT AGREEMENT

Please indicate the week(s) you would like your child to participate in:

WEEK 1: June 30th – July 4th ($120) *Closed July 1st for Canada Day*
WEEK 2: July 7th – July 11th ($150)
WEEK 3: July 14th – July 18th ($150)
WEEK 4: July 21st – July 25th ($150)
WEEK 5: July 28th – August 1st ($150)
WEEK 6: August 5th – August 8th ($120) *Closed August 4th for Saskatchewan Day*
WEEK 7: August 11th – August 15th ($150)
WEEK 8: August 18th – August 22nd ($150)
WEEK 9: August 25th – August 29th ($150)

For our daily rate option ($50/day), please indicate the day(s) you would like your child to participate in:

*Note: We do not refund or re-allocate missed attendance days unless adequate notice of changes to this contract is provided (please see “Changes to Contract and Cancellation Policy”). By agreeing to this contract, you are committed to the associated fees, regardless of your child’s attendance.

Release Password:

The safety of your child is of utmost importance to us. Therefore, until BGC Battlefords staff become familiar with the child’s parents/guardians, you will be asked for a release password OR government issued photo ID. Anyone picking up the child other than the parents/guardians will be asked for the release password and/or their government issued photo ID.

Release Password: *

CAMP DETAILS

• Hours of Operation: Monday to Friday from 7:30am to 5:30pm (CLOSED Tuesday, July 1st & Monday, August 4th)

• Eligibility: Children must be 5 to 14 years old to attend our camps.

• Registration: Spaces are limited, and registrations are accepted on a first-come, first-served basis. To secure your child’s spot, send payment with this form. A cancellation/waitlist will be maintained to contact parents/guardians if space becomes available.

• Field Trips & Special Activities: Included in the registration fee. Additional permission forms and details will be available closer to the date.

• Meals: A daily breakfast, lunch, and afternoon snack will be provided at no extra cost.

• Walking/Biking Permission: If your child will walk or bike to and/or from the program on their own, a separate permission form is required. Please contact our office.

Do you have approval from another organization to cover the fees? If so, please provide us with their information:

*Written approval from the organization is required prior to your child(ren) attending the summer camps.

PAYMENTS

Weekly rate: $150.00 Daily Rate: $50.00

Please note: The fee for Week 1 (June 30 – July 4) and Week 6 (August 5 – August 8) is reduced to $120 due to the statutory holidays on July 1st and August 4th.

Payment (or written notice of cancellation/changes) is due by 12:00pm (noon) the Monday before your child’s scheduled week of attendance. Failure to pay by this time may result in your child losing their spot. If payment is received after 3:30 pm Friday or over the weekend, your child may not be able to attend until after 8:30 am on Monday, as staff will need time to verify payment and update attendance.

Payment methods: E-transfer: Send payments to ac.bcgb@stnemyap with your child’s first and last name in the memo section. No password required.

In-person payments: Our office is open to accept cash, debit, or credit card payments Monday to Friday from 8:30am to 3:30pm.

CHANGES TO CONTRACT AND CANCELLATION POLICY

By signing this agreement, you are committing to the contract and fees for the 2025 Summer Adventure Day Camps. ALL CHANGES/CANCELLATIONS MUST BE SUBMITTED BEFORE 12:00pm (NOON) MONDAY OF THE WEEK BEFORE THE REQUESTED CHANGE.

Cancellations or changes will not be accepted over the phone or through program staff. Please contact our office to request a Contract Amendment Form or visit our website www.bgcbattlefords.ca. Our office hours are 8:30am – 3:30pm, Monday to Friday, but our online form and e-mail are available 24/7.

Note: Our Contract Amendment Form can also be used to ADD weeks or days – a new registration form is not necessary.

Refunds will be issued by September 30th, 2025, only if the proper notice is given.

Signature of Parent/Guardian: *

CUSTODY AND/OR COURT ORDER

If a custody or court order exists, a copy of the order must be given to BGC Battlefords. The parent/guardian is responsible for providing accurate and up to date information concerning the legal guardianship of the child. Without a custody or court order on file, BGC Battlefords cannot deny access to the non-enrolling parent.

Custody and/or Court Order *

Not Applicable
I have provided BGC Battlefords with legal documentation (custody or court order). Please see below.

Please attach a copy of the court order to this form or submit via email to ac.bcgb@ofni.

Click or drag files to this area to upload. You can upload up to 5 files.

Please list anyone who is NOT ALLOWED to pick up your child:

Signature of Parent/Guardian: *

MEDIA CONSENT & RELEASE

BGC Battlefords has the right to use any artwork, photographs, video, and/or audio of my child while participating in Club activities for the purpose of advertisement and promotional campaigns in the future. My child’s image may be published or used in newspapers, promotional videos, television commercials, television news items, program brochures, posters, social media sites, etc. or otherwise displayed to the public or used for other educational/fundraising purposes, either in whole or in part by BGC Battlefords, BGC Canada and/or external partners. No names will ever be used in association with a child’s image without written permission of the parent/guardian.

Media Consent & Release *

Yes, I agree
No, I do not agree

Signature of Parent/Guardian: *

PARENT/GUARDIAN HANDBOOK

PARENT/GUARDIAN HANDBOOK *

I acknowledge that I will/have read and adhere to the information provided in the Parent/Guardian Handbook.

Please view our Parent/Guardian Handbook here. Paper copies will also be available at our office.

Signature of Parent/Guardian *

MEMBERSHIP CONTRACT

Parents/Guardians: Please read and initial beside the following statements agreeing to:

• I understand that any violations of the Parent/Guardian and/or Participant Codes of Conduct may result in termination of services. *

• I agree that under no circumstances are BGCB staff members, volunteers or board members responsible for lost or stolen belongings. *

• With full knowledge of the existence and nature of my legal right and in consideration for the opportunities provided to my child by BGCB, I waive my legal right against BGCB, its staff, volunteers, or Board of Directors for any injury or damage suffered during or by reason of practicing, participating or assisting in a BGCB service, program, or experience. *

• I further authorize the application of emergency medical attention and undertake to be responsible for any hospitalization, medical, ambulance or other expenses. *

Date & Time (am/pm): *

Date

Time

Signature of Parent/Guardian: *

*If you would like a copy of this registration form, please contact our office at (306) 445-0002 or email ac.bcgb@ofni. Thank you. Let’s have a great summer!

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