Demande de camping-car 2017

Étape 1 de 5

20%

Note Date changes for 2018. Attached you will find our Camper application and information package for the summer of 2018. Please read and fill out all the necessary information.

New information for 2018.
- Senior, Campers Grade 9 and up begins on Friday, July 6 until Wednesday, July 18
  - Transportation is available $40:
    -To Camp Friday, July 6
    -From Camp Wednesday, July 18
- Junior A Camp ages 5 to 10 begins Friday, July 20 until Friday, July 27
  - Transportation is available $40:
    -To Camp Friday, July 20
    -From Camp Friday, July 27
- Junior B Camp ages 10 – 13 begins Friday, July 27 until Friday, Aug 3
  - Transportation is available $40:
    -To Camp Friday, July 27
    -From Camp Friday, Aug 3
- Special Camp begins on Friday, Aug 3 until Friday, Aug 10
  - Transportation is available $40:
    -To camp Friday, Aug 3
    -From camp Friday, Aug 10
- Bus departure time is 1:00 pm each Friday from the Bob Rumball Centre for the Deaf, 2395 Bayview Ave
- Bus going to Camp from Barrie will be there at 2:00pm
- Transportation home bus will be in Barrie at 11:00am and BRCD at 12 noon
- The Barrie location for pick up and drop off will be the north bound On Route Gas Plaza north of Mapleview exit in Barrie. The actual address is 200 Fairview Rd, Barrie, ON
- Campers being dropped off at camp: Campers are to arrive between noon and 3pm
- We ask parents to drop their camper and leave so that their child can get settled into the program.
- Parental visits must be arranged and approved by the Camp Director, Derek Rumball.
- Note that the information you have provided regarding transportation will be strictly adhered to in an attempt to insure the safety of your child. Any changes to the above information must be made in writing a full day prior to your child’s last day at camp and faxed to 416 447-7465 and or scanned and emailed to deafcamp@bobrumball.org. It must show a hand written signature of the parent, guardian or caregiver.
- If there is any dispute your child will remain at camp and it will be your responsibility to pick him/her up.
- An additional charge of $80.00/day will be incurred by the parent.
- Blackberry, IPhones, Cellphones are NOT allowed. It disrupts our program and on occasion ends up having a negative impact on the camper and the camp itself. We are asking parents to keep their children’s devices at home.
- We will not be responsible whatsoever for the care and safety of personal electronic devices such as: game boys, PSP, blackberries or cell phones, iPods, iPads or any other personal items of value that should have been left at home.
- The camp does not provide internet access. There will be no means of Facetiming or Skyping with your camper, unless there is an emergency.
- Your camper will not need any money. The Tuck shop is included in your Camp fee.
- Subsidy requests must be made by May 1, 2018. Requests must be made in writing with justification of your need. Approvals of subsidies are at the discretion of the Camp Director. Subsides of up to 50% of campers fees are offered.
- Unless otherwise stated, your camper’s image and likeness may be used on social media. This includes Facebook, Instagram, Youtube and Twitter. Please make sure you sign and return the PICTURE TAKING CONSENT FORM
Every camper will undergo a Head lice and general health inspection prior to getting on the bus in Toronto or Barrie and upon arrival at the camp. It is the parent\caregiver responsibility to ensure that their camper is free of Head lice and in good physical health.

CAMPERS WITH HEADLICE WILL NOT BE PERMITTED TO ATTEND CAMP. TREATMENT IS AVAILABLE ON SITE FOR $100 PER CHILD. THIS DOES NOT GUARATEE YOUR CHILD WILL BE PERMITTED TO GO TO CAMP. PLEASE TAKE CARE OF ANY HEADLICE SITUATIONS BEFORE YOU ARRIVE FOR THE BUS OR DRIVE TO CAMP PARENTS\CAREGIVERS ARE RESPONSIBLE FOR CLOTHING AND BEDDING IS FREE OF BEDBUGS. BEDDING WILL BE INSPECTED UPON ARRIVAL AT CAMP. $150 CLEANING CHARGE WILL BE APPLIED IF NECESSARY TO INDIVIDUALS

Our Senior Camp Program is targeted towards our 13 to 17 year olds. It is highly recommended that if a Camper has the ambition of being staff at the camp when they are 16, they enroll in the Leadership in Training (LIT) Program that will run during the Senior Camp Session. This training program is ideal for campers who are 14 and 15. In order to stay on for Junior Camp as a staff person, one must complete the LIT Program. Please select this option on your application form.

Our Junior A program is targeted for our Grade 6 to 8. Junior B program is Kindergarten to Grade 5.

All campers will have the opportunity to participate in activities that include typical camp activities from arts and crafts, swimming and canoeing to the more physically active and competitive activities such as water skiing, wake boarding and outdoor adventures. For more information please visit our website www.bobrumball.org.

Our Special Needs Campers: Is for children and adults and it’s a more relaxed "resort" type environment. Campers who require 1:1 workers and have special housing requests will be dealt with on a first come first serve basis. There are limited accommodations and everyone's request will be taken into consideration. Agency staff that are 1:1 are required to pay an additional $175.

Incomplete applications do not secure your campers position at camp. Please see the check list.
Camper Information
Name*
Prénom Nom
Birthday*
Date Format: YYYY dash MM dash DD
Address*
Adresse postale Adresse ligne 2 Ville État / Province / Région ZIP / Code postal Pays
Email*
Sex*
Male
Female
Are you:*
Deaf
Hearing
Hard of Hearing
Session Requested*
SENIOR July 6 -July 18
JUNIOR A July 20 –July 27
JUNIOR B July 27-Aug 3
SPECIAL Aug 3 - Aug 10
Parent Guardian/Agency
Guardian 1*
Prénom Nom
Guardian 1 relationship to child:*
Guardian 2
Prénom Nom
Guardian 2 relationship to child:
Phone*
RES #
BUS #
Other
If Parents are separated or Divorced, are there any special visitation arrangements?
Emergency Contact Information
Name*
Prénom Nom
Phone*
Address*
Adresse postale Adresse ligne 2 Ville État / Province / Région ZIP / Code postal Pays
Relation to Camper*

Transportation

Note that the information you have provided regarding transportation will be strictly adhered to in an attempt to insure the safety of your child. Any changes to the above information must be made in writing prior to your child’s last day at camp. If there is any dispute, your child will remain at camp and it will be your responsibility to pick him/her up
To Camp*
I will drive my camper to Camp
My camper will travel on the camp bus from BRCD
My camper will travel on the camp bus from Barrie
From Camp*
I will pick up my camper from camp
My camper will travel on the camp bus to be dropped off at BRCD
My camper will travel on the camp bus to be dropped off at Barrie

Picture Taking Consent

The Bob Rumball Camp of the Deaf use pictures and/or videos for newsletters, volunteer appreciation, family members, and social media purposes.

This requires prior consent.

I GIVE CONSENT give the Bob Rumball Camp of the Deaf permission to take CAMPERS NAME:
Picture and or image for use of the above mentioned uses.
PARENT\GUARDIAN NAME:
Date
Date Format: YYYY slash MM slash DD

Signature:
I DO NOT GIVE CONSENT give the Bob Rumball Camp of the Deaf permission to take CAMPERS NAME:
Picture and or image for use of the above mentioned uses.
PARENT\GUARDIAN NAME:
Date
Date Format: YYYY slash MM slash DD

Signature:

Camp Medical
Health Card #*
Allergies*
Do you use an Epi-Pen?*
Yes
No
Date of Last Tetanus Shot*
Date Format: YYYY dash MM dash DD

Food Restriction*
Do you have any Restricted Activities
Do you have or have you ever had*
Heart Defect/ Disease
ADD/ ADHD
Hay Fever
Stomach/ Bowel Problems
Visual Problems
Operations
Constipation
Ear Infections/ Earaches
Seizures/ Epilepsy
Bed-Wedding/ Incontinence
Phobias
Hypertension
Sleep-walking/trouble falling asleep
Migraines / Headaches
Hepatitis
Asthma
Diabetes
AIDS or HIV Positive
Bleeding/ Clotting Disorders
Emotional Problems
Skin Problems
*NONE*
Other Medical Problems and how to address them (response to seizures, etc.)
Any Treatments to continue at camp
Medication
Name of Medication #1
Reasons for taking it
When is it given?
Breakfast
Lunch
Bedtime
Other
If other, enter timeframe
Dose (mg/ml)
How Many
How is it given
Name of Medication #2
Reasons for taking it
When is it given?
Breakfast
Lunch
Bedtime
Other
If other, enter timeframe
Dose (mg/ml)
How Many
How is it given
Name of Medication #3
Reasons for taking it
When is it given?
Breakfast
Lunch
Bedtime
Other
If other, enter timeframe
Dose (mg/ml)
How Many
How is it given
Name of Medication #4
Reasons for taking it
When is it given?
Breakfast
Lunch
Bedtime
Other
If other, enter timeframe
Dose (mg/ml)
How Many
How is it given
Name of Medication #5
Reasons for taking it
When is it given?
Breakfast
Lunch
Bedtime
Other
If other, enter timeframe
Dose (mg/ml)
How Many
How is it given
Name of Medication #6
Reasons for taking it
When is it given?
Breakfast
Lunch
Bedtime
Other
If other, enter timeframe
Dose (mg/ml)
How Many
How is it given
Name of Medication #7
Reasons for taking it
When is it given?
Breakfast
Lunch
Bedtime
Other
If other, enter timeframe
Dose (mg/ml)
How Many
How is it given

Health Card*
Types de fichiers acceptés : jpg, gif, png, pdf.
Please upload a scanned image of your child's health card here.
Signed waiver form*
Types de fichiers acceptés : jpg, gif, png, pdf.
Please upload a scanned image of your child's signed waiver form.
CONDITIONS OF ENROLMENT

The Camp Director reserves the right to dismiss any camper who he deems to pose a potential risk to the safety and rights of others, or who appears to have rejected the reasonable controls of the camp.

The parents/guardians submitting this application are those having legal custody over the child. Conditions of custody, if applicable will be fully communicated to the camp in writing and a photocopy of the section of the court order referring to visitation rights will also be submitted. This information will be kept confidential.

Every precaution is taken to insure the safety and good health of our campers, but in the event of illness or accident, the Ontario Camp of the Deaf, including the camp directors, and their staff, and the employees of facilities outside camp grounds are hereby released from liability. Each camper must be covered by Provincial Health or equivalent medical insurance.

In the event that a camper requires any special medications, X-rays, or treatment beyond that which the camp provides, the parent/guardians will be notified immediately. Parents/guardians will also be informed of any additional charges for this special care.

I have signed and returned the Picture Taken Consent Form

We cannot guarantee a total peanut and/or nut free environment. Campers with those allergies will be safe guarded accordingly.

Parents who drop campers at camp are asked to leave once their child is settled into the program

Your enrollment package checklist:*
a complete camper application with complete transportation information
complete medical information, signed and dated release form
signed and dated assumption of risk and responsibility release
cheques for $40 registration fee and postdated cheque, dated June 1, 2017 for the balance of the camper total camper fees
a clear photocopy of the campers health card
INCOMPLETE APPLICATIONS WILL NOT BE CONSIDERED.

Your application is complete when we receive your full payment.

Each NSF cheque is subjected to $20 administration fee

Please make cheque / bank draft / money order payable to: Bob Rumball Camp of the Deaf

Additional Information
Please enter any additional information or comments that you would like us to know.
Important!*
I have read and understood the foregoing acknowledgement of risk, assumption of risk and responsibility, and release of liability. I understand that by submitting this form I may be waiving valuable legal rights.
CAPTCHA

Make sure you read the following documents before submitting the Camp Application:

Assumptions of Risk and Responsibility and Release of Liability

Conditions of Enrollment

Transportation Information

Demande de camping-car 2017

Étape 1 de 5

Camper Information

Parent Guardian/Agency

Emergency Contact Information

Transportation

Picture Taking Consent

Camp Medical

Medication