Day Camp Application 2010

Enrollment - Contact Information

Please complete the following information.

Mailing Address
e.g., Dr. & Mr. Smith-Jones Title(s) & Name(s):
Address:
City:
 Province:
 Postal Code:
Contact Phone:
 Contact Email:
 RHCC Member #?:

Parents / Guardians
Name:
 Cell Phone:
 Office Phone:
Name:
 Cell Phone:
 Office Phone:
Marital Status:

Secondary Contacts If Parents Cannot Be Reached
Name:
 Home Phone:
 Cell/Office Phone:
Family Doctor:
 Phone:
    
 

Check this box to consent to the following:

Permission Form: I/we agree to allow my/our child(ren) to participate in all camp activities and in supervised trips to places not on camp property. I/we hereby apply for registration for the herein named child(ren) for the camping services indicated on this application. (a) To give camp officials authority to act on my behalf. (b) To release and indemnify R.H.C.C. Holdings Ltd. and its staff from any and all claims for damages arising as a result of any injury, accident or otherwise sustained by the herein child(ren) arising from participation in any camp activities. I/we consent to the use of the camper's likeness for publicity purposes. I/we have read the refund policy.

Cancellation and refund policy (please read carefully)

  • Your deposit and any post dated payments are refundable (less a service charge of $175 per child), provided written notice is received prior to April 30, 2010. After that date there will be no refunds of fees.
  • Fees cannot be refunded for days missed unless consecutive weeks occur. A refund of 50% of the unused fees will be made upon written request including a doctor's certificate.
  • Refunds will be issued in September 2010.
  • Refunds of food or busing will be given as a credit for any youth or camp programs.
  • No other refunds are possible.
  • This policy will be strictly adhered to.

Enrollment - Camper #1

 
First Name:
 Last Name:
Sex:
Male     Female 		Date of Birth (mm/dd/yyyy):
Health Card #:
 Present Swim Level:

Friends Preferred as Group Mates (2 Only)
Friend #1 Name:
 Friend #2 Name:
 
Choose Day Camp Season: Please indicate choice of Camp:
Date Range of Attendance:
  

Options

This camper would like lunch provided.
This camper would like transportation provided.
This camper would like to stay extended hours.

 

 

Enrollment - Camper #2

 
First Name:
 Last Name:
Sex:
Male     Female 		Date of Birth (mm/dd/yyyy):
Health Card #:
 Present Swim Level:

Friends Preferred as Group Mates (2 Only)
Friend #1 Name:
 Friend #2 Name:
 
Choose Day Camp Season: Please indicate choice of Camp:
Date Range of Attendance:
  

Options

This camper would like lunch provided.
This camper would like transportation provided.
This camper would like to stay extended hours.

 

 

Enrollment - Camper #3

 
First Name:
 Last Name:
Sex:
Male     Female 		Date of Birth (mm/dd/yyyy):
Health Card #:
 Present Swim Level:

Friends Preferred as Group Mates (2 Only)
Friend #1 Name:
 Friend #2 Name:
 
Choose Day Camp Season: Please indicate choice of Camp:
Date Range of Attendance:
  

Options

This camper would like lunch provided.
This camper would like transportation provided.
This camper would like to stay extended hours.

 

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