Camp Forms

Thank you for registering your child in The CUP: Wholeness Centre’s camp. Please fill out the following forms prior to the beginning of camp.

At drop-off please ensure both you and your child are wearing masks and maintain social distance.  We are recommending that masks be worn throughout the day when in close proximity to others.    

Pick-up will be at 4:30. Each child must be signed out, so please wait to be called.  

Please bring:

-Labelled water bottle -Hat/Sunscreen  

-Weather appropriate clothing

-Nut-Free Lunch and snacks 

-Weather appropriate footwear  

- Change of clothes

- PFD Vest

And please complete The CUP: Wholeness Centre’s self-assessment checklist before attending.

  

Let’s GO WILD! together! 

Michelle Ulmer, 

Directory of Youth and Family Programming  

The CUP: Wholeness Centre

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Is your child a swimmer?
Is your child a swimmer?
Is your child a swimmer?
Is your child a swimmer?

Parent/ Guardian 1

Permission to Pick Up

Parent/ Guardian 2

Permission to Pick Up

Emergency Contact 1

(Must be local and available to pick up your child during the time that your child is in our  care) 

Permission to Pick Up

Health Information

Does your child/ children have any allergies?
Is your child/children's allergy life-threatening?
Does your child/children have any medical concerns (asthma, diabetes, ADHD etc.)?
Has your child/children received a diagnosis from a medical professional?
Does your child/ children take any regular medication that needs to be adminstered during camp hours?

Social Information

Who has guardianship of the child?
Is there a custody agreement?
Is it a joint custody?
Upload copy of agreement

Consent

I, the undersigned, permit my child to participate in the full range of activities. I also authorize CUP: Wholeness Centre in the event of accident or illness affecting the below named child, to authorize on my behalf all procedures; including admission to hospital and necessary treatment therein, as they may deem essential for the care and well-being of the child.  Such actions are only to be taken when immediate contact with the undersigned cannot be made.  It is understood that CUP: Wholeness Centre is not responsible for medical care or ambulance costs.

I, the undersigned, release and discharge any and all rights and claims for damages and causes of suit or action that I  or my child have at any time against CUP: Wholeness Centre, along with their employees and agents, for any and all injuries or losses suffered by my child as a result of participating in CUP: Wholeness Centre Program. 

Thanks for submitting!

Pro-D Day Registration

To register, please take the time to fill out the information below.

Water Waiver

I, the undersigned,  am exercising my own free choice to permit my child to participate in dragon boating. I hereby release and discharge, indemnify and hold harmless The CUP, its members, directors, operators, volunteers, and participants, and any other persons or entities acting on their behalf, and the successors and sponsors for any and all of the aforementioned persons, and entities, against all claims, demand, and causes of action whatsoever, either in law or in equity, relating to injury, disability, death or other harm, to persons or property of both, arising from my participation in and/or at any of The CUP's sanctioned activities, events, practice sessions, social activities or travel, due to any cause whatsoever, including negligence, breach of contract or breach of any statutory duty of care. 

 

I acknowledge that this agreement is binding on not only myself but my next of kin, heirs, executors, administrators, and assigns. 

I acknowledge that I have been informed of hazards and risks which may be associated with the participation in the above-mentioned activity, I understand accept and assume those hazards and risks, and waive all claims against the sponsors and The CUP. I understand that I am solely responsible for any costs arising out of bodily injury or property damage sustained through my child's participation in normal or unusual acts associated with the above-named activity. 

Thanks for submitting!

COVID-19 Screening Form

Please fill out the following form no more than 48hrs before the start of the program

Has your child/children travelled outside of Canada in the last 14 days?
Has someone you are in close contact with tested positive for COVID-19 in the last 14 days?

Are you/your child/children in close contact with a person: 

who recently travelled outside of Canada AND is sick with COVID-19 symptoms?
who is sick with new respiratory symptoms
who has symptoms and who is awaiting COVID-19 test results?
Do you or your child/children have a fever? (temperature ≥ 37.8 °C)
Do you have any of the followin symptoms
Are these symptoms typical for you (i.e. history of allergies, migraines, other known medical condition that usually causes these symptoms)?

Thanks for submitting!