2023 Camp Awesome Registration Form

Thank you for completing the following application to register your child(ren) in the Camp Awesome day camp program. Camp programming will be offered between 8:00 am and 5:00 pm including before and aftercare supervision at no additional cost. Camp Fees: $150.00 per child per week. Once your camper application is submitted, Camp Awesome Staff will be in contact with you if there are any questions and/or to confirm your registration. Note that this is an application to attend camp and all campers are not fully registered until you receive your confirmation letter. If you have questions or require assistance completing the application please contact the Camp Awesome Director at campawesomeottawa@gmail.com

Please complete the following sections. An asterisks (*) indicates a mandatory field and will require an answer to continue with the form. You can also save your progress and return to the form at any time.

Camper Name(Required)

First Last

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Email(Required)

Enter Email Confirm Email

Phone(Required)

Camper Date of Birth(Required)

Camper Age at Time of Camp(Required)

Please note that campers should be at least 4 years of age to attend camp, and have completed at least one year of school, ie Junior Kindergarten.

Community of Faith (leave blank if not applicable)

Church or Community of Faith the camper attends.

Parent/Guardian Information (first point of contact)

Name(Required)

First Last

Cell Phone(Required)

Work Phone

Home Phone

Email(Required)

Parent/Guardian Information (second point of contact)

Optional: This is the second person we will contact if needed. Please indicate below if this person would like to be included in camp emails.

Parent/Guardian Name

First Last

Cell Phone

Work Phone

Home Phone

If different from above.

Email

Please include this parent/guardian's email when sending camp information.

Yes

No

Emergency Contacts

These people know my child and have agreed to be contacted in the event that I am unable to be reached.

Emergency Contact 1 Name(Required)

First Last

Emergency Contact 1 Phone(Required)

Emergency Contact 2 Name(Required)

First Last

Emergency Contact 2 Phone(Required)

Pick Up Authorization

These people are known to my child and have agreed to pick up my child in the event that I am unable to. These people are aware that they will need to present photo identification to Camp Awesome staff prior to my child being released to their care.

Pick Up Person Name

First Last

Pick Up Person Name

First Last

Camper Medical Information

Please complete all sections based on the camper medical information. This information is kept private and only shared with camp staff as necessary for the provision of health care and in the case of an urgent medical situation.

Name(Required)

First Middle Last

Ontario Health Card Number(Required)

If the camper does not possess an OHIP card a copy of their medical insurance must be attached

Ontario Health Card Expiry Date

Camper Allergies(Required)

Please describe any allergies the camper has. Include the type of exposure (example: ingested) reaction (example: anaphylaxis) and treatment (example: Epi-Pen). If no allergies indicate N/A

Camper Dietary Restrictions(Required)

Please list any dietary needs the camper has (example: lactose intolerant, vegetarian, vegan, gluten-free) If no dietary needs indicate N/A

Camper Medication(Required)

Please do not send any medication to camp, other than those needed for emergency use, such as inhalers or EpiPens. Campers will be required to carry these on them at all times unless previously arranged with the Camp Coordinators. Please list any medications your child will bring to camp including medication name (example Ventolin), dosage (example 2 puffs) and time to administer (example as needed). If no medication indicate N/A

Camper Medical History

Please describe any relevant health conditions or medical information for this camper that is not already indicated above (such as seizures, anxiety, heart condition, hearing or sight difficulties, recent operations or injuries) If no further medical information indicate N/A

Camper Profile

Providing this information will help the Camp Awesome Staff prepare for your child's camp experience. All information will be kept in the strictest confidence and will be used only to help the Camp Director and Camp Staff to provide the best experience for your child. Please note that Camp Awesome Staff receive training in caring for the general needs of campers. Please contact the Camp Director campawesomeottawa@gmail.com if your camper may require additional support.

Camper Preferred Name(Required)

First Preferred Nickname

Has your child attended any camps before?

Yes

No

If yes, please describe their experience at camp

Is there anything your child is excited or anxious about coming to camp?(Required)

Life at Home(Required)

Please tell us about the camper's family. (brothers, sisters, blended family, only child etc.) This helps camp staff in understanding the family dynamic.

Are there any custody arrangements camp should be aware of?(Required)

yes

no

If yes please describe.

Does your child receive additional support during the school year?(Required)

If yes, please describe. If no please indicate N/A.

Life at Camp(Required)

Does your child have any particular fears we should know about (e.g. spiders, thunderstorms)? What are their coping techniques?

Staff Support(Required)

How does your child react if they are angry or upset? What have you found is the best way of responding to your child in these situations?

Are there any particular activities your child enjoys during their free time (sports, music etc.)?(Required)

Additional Information

Is there any other information that you can give us to help the staff better understand your child and make this the most enjoyable experience possible?

Consent and Privacy

Media Consent(Required)

I as the legal parent/guardian of the child listed on this form permit such child to be photographed and video recorded for the purpose of promotional materials for Camp Awesome and the Eastern Ontario Outaouais Regional Council. Promotional materials may include but not limited to: use on websites or social media, brochures, posters or materials used for fundraising.

Yes

No

Parent/Guardian Name

In completing this section it will be recorded as your digital signature for the media consent and declaration of consent.

First Last

Today's Date

Camp Awesome 2023 - Camper Application

Parent/Guardian Information (first point of contact)

Parent/Guardian Information (second point of contact)

Emergency Contacts

Pick Up Authorization

Camper Medical Information

Camper Profile

Consent and Privacy

Select Camp Weeks

Camper Fees and Payment Options

End of Registration - click submit to proceed.

Section Break