CANADIAN RED CROSS WATER SAFETY DAY CAMP
REGISTRATION FORM
This year the Canadian Red Cross will be offering Water Safety Programs across Prince Edward Island.
It will consist of our Red Cross swimming lessons, as well as our Boating, Junior Outdoors Club (JOC) nature programs.
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Registration fees: Full Day Camps
$120 / individual
$320 / family (3 or more)
Half Day Camps
$85 / individual
$220 / family (3 or more)
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Camp Locations and Dates:
Charlottetown Day Camp* - June 30-July 4, 2014(full day camp)
Stratford Day Camp*- June 30-July 4, 2014(full day camp)
Tignish Day Camp - July 7-18, 2014(half day camp)
Summerside Day Camp - July 7-18, 2014(full day camp)
O’leary Day Camp - July 21-August 1, 2014(half day camp)
Souris Day Camp- August 4-15, 2014(half day camp)
Marco Polo Land Day Camp - August 18-22, 2014(full day camp)
Lennox Island Day Camp - August 18-22, 2014(full day camp)
Twin Shores DayCamp- August 25-29, 2014(full day camp)
Argyle Shore Day Camp - August25-29, 2014(full day camp)
(*As the camps will be closed for Canada Day the Charlottetown & Stratford camps will only be 4 day camps. The cost for these camps will be $96/individual)
Registration: Camp dates fill up quickly so remember to register early via phone, Community Registration Days listed below or at our Red Cross office at 62 Prince St., Charlottetown.
Register before July 1stto receive a 10% discount on registration
Community Registration Days
O’Leary Recreation Office, Main St.– May 24, 2014 from 9:30am-12pm
Tignish Co-op, 285 Mall St. – May 31, 2014from 9:30am-12pm
Charlottetown Red Cross Office, 62 Prince St. – June 7, 2014 from 9:30am-12pm
Souris,Main St. Gazebo – June 14, 2014 from 9:30am-12pm
Selected Camp Location: ______
Child’s Name (Please Print) / Health Card Number / Date of Birthdd/mm/yy / Swimming Level** / Boating ability***
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**If you are unsure of what level currently is please fill with ‘test’
***Boating levels – Basic boating, Survival boating, Rowing 1, Rowing 2, Canoe 1, Canoe 2
Half Day camps- you can specify your preference of an morning or afternoon session but those who register first will get first selection. Red Cross cannot guarantee which session you will be loaded into.
Half day camps – Please circle session you would prefer: MorningAfternoon
Parents/Legal Guardian: ______
(Please print name)
Complete mailing address: ______
Community or District (for busing purposes):______Civic Address ______Postal Code: ______Email Address: ______
Telephone: Name - ______Contact Number ______
Name - ______Contact Number ______
In case of emergency call – Name ______Contact # ______
Youth Volunteer Work Experience!
We are offering an exciting youth volunteer experience for the summer! We are looking for youth ages 13-15 who are interested in volunteering their time during ourvarious Water Safety Day Camps. We need your help to make our program a success! For more information or if you know anyone who may be interested, please contact Red Cross at 682-6262.
General Points about Camps
1.Red Cross is not responsible for money or goods lost or stolen during the program.
2.Registration fees NOT accepted at beachfront – day camp.
3.Refunds are granted for medical & family emergencies only.
4.INFORMATION CONCERNING ANY SPECIAL MEDICAL CONDITIONS MUST ACCOMPANY THIS FORM.
5.Each child should bring 1 beach towel, a nutritious snack, WARM CLOTHES: sweatshirt (preferably hooded), sweat pants, hat, sun screen and an old pair of sneakers OR sandals that can get wet. Children MUST wear their bathing suit to the program.
6.Students should participate in classes and activities with energy, focus and a positive attitude.
7. A parent or responsible adult must accompany pre school age children. Preschool children must be at least five years of age.
8. Red Cross Water Safety Day Camps are PEANUT FREE ZONES.
9. Boating Program pre requisites - 9 years of age & registered in Red Cross Swim level 5.
10.Only students with signed waiver forms and paid in full are permitted to participate in the Day Camp Programs.
11.Rainy Day Program – In case of inclement weather there will be indoor sessions.
12.For Financial Assistance contact KidSport™at 1-800 247-6712.(KidSport™ is a children’s charity dedicated to assisting children of families facing financial obstacles to participate in community sport programs).
Does your child have any medical conditions/allergies we should be aware of?
Upon completion of Registration process and payment arrangements, parents will receive a detailed camp enrollment package that will include bussing arrangements, schedules, camp requirements and policies.
Release: In consideration of the candidate(s) being accepted and allowed to participate in the Water
SafetyProgram, I hereby waive on behalf of myself and said candidate as against the Canadian
Red CrossSociety, their agents/employees or other persons acting on behalf, all claims, demands,damages, suits or other proceedings attributable to any such accident/incidents arising in any manner out ofthese classes resulting in death, injury, or damage either to persons or property.
Signed: ______
Parent/Legal Guardian's SignatureDate
Payment by credit card is accepted via phone, mail or in person at our Charlottetown office.
Please Make Cheques Payable to:“Canadian Red Cross”
FOR OFFICE USE ONLY
Notes section: “Water Safety Day Camp- (location)”
AMOUNT PAID: ______RECIEPT #:______
FOR FURTHER INFORMATION OR TO REGISTER, PLEASE CONTACT
ALANNA GREEN AT THE RED CROSS AT 628-6262 ext. 4.
62 Prince St.
Charlottetown, PE
C1A 4R2
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