HOME
SUMMER CAMPS
RENT
JOBS
VOLUNTEER
WOHELO BLOG
ABOUT
Loading...
REGISTER NOW
TEEN LEADERSHIP Camp Registration 2019
Name
*
Address
*
Street Address
City
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland & Labrador
Northwest Territories
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
Province
Postal Code
Birth date (d/m/y/)
*
Age
*
Parent/Guardian name
*
Parent/Guardian E-mail address
*
Parent/Guardian Address (if different from above)
*
Home Ph #
*
Work Ph #
Cell Ph #
I give permission for my child to be photographed/videotaped for use in marketing materials
*
Yes
No
Any and all info on this form is for the sole use of Camp Wohelo, it is not given out or sold.
Is there are any restrictions as to who may pick up your child and/or any custody issues pending?
*
Emergency contact
*
Name
Phone
Relation
Second Emergency contact
*
Name
Phone
Relation
A copy of Health cards for each person must be attached to this form, or be brought with you to camp.
Accepted file types: jpg, gif, png, pdf.
Doctor’s name
*
Doctor's Phone Number
List allergies and care instructions
*
List all medical conditions, mental, emotional, physical and behavioral challenges that your child may have including, skin conditions, asthma, bed-wetting, epilepsy, diabetes, heart conditions, hyper-activity, etc.
*
Will your child be on medication
*
Yes
No
Date of last Tetanus shot (enter date or comment)
Comment
Special diet
List all medications
Child’s swimming ability
*
Permission to go offsite with staff, eg. a hike
*
Yes
No
Cabin mate preferred
Where did you hear about Camp Wohelo? been before, a friend, an ad, a brochure( where did you get it?) or other (please be specific)
*
Permission to administer the medications, prescription and/or OTCs that you send for your child.
*
Yes
No
All medication, prescriptions and/or over the counter (OTC may include gravel, Tylenol, Benadryl, etc.), must be brought by the camper, be in the original container and given to the camp medic upon arrival.
In case of medical emergency, I understand that every effort will be made to contact the parent or guardian of the camper. In the event that I cannot be contacted, I hereby give permission to the physician selected by the Director to hospitalize/secure proper treatment for my child as named above. I understand that in an emergency, my child maybe transported in a personal vehicle and I hereby waive my right, and that of my child, to any claim against Camp Wohelo, its employees or volunteers.
*
Yes
CAPTCHA
