Summer Day Camp Info & Registration Forms

SUMMER DAY CAMPS

MONDAY - FRIDAY 9A.M. - 3P.M.

AGES 5-10 - $225.00 PER WEEK - ONLY 8 CHILDREN PER GROUP

  • MONDAY JULY 2 2018 - FRIDAY JULY 6 2018
  • BAGGED LUNCH
  • MONDAY JULY 9 2018 - FRIDAY JULY 13 2018
  • HAT, TOWEL, SUNSCREEN
  • MONDAY JULY 16 2018 - FRIDAY JULY 20 2018
  • LIFE JACKET / WATER WINGS
  • MONDAY JULY 23 2018 - FRIDAY JULY 27 2018
  • BUG SPRAY (PLEASE LABEL ALL)
  • MONDAY JULY 30 2018 - FRIDAY AUGUST 3 2018
  • ACTIVITIES;
  • MONDAY AUGUST 6 2018 - FRIDAY AUGUST 10 2018
  • HIKING
  • MONDAY AUGUST 13 2018 - FRIDAY AUGUST 17 2018
  • SWIMMING
  • MONDAY AUGUST 20 2018 - FRIDAY AUGUST 24 2018
  • CRAFTS
  • MONDAY AUGUST 27 2018 - FRIDAY AUGUST 31 2018
  • OUTDOOR GAMES

Early drop off 7:30a.m. to 8:45a.m. is an extra $40.00 per week

Late pickup after 3:00p.m. is an extra $50.00 per week

Download
Summer Day Camp Medical Form

POPLAR FOREST SUMMER DAY CAMP MEDICAL FORM

CAMPER INFORMATION

One form per child please, please print.

Child's name :

PARENT/GUARDIAN CONTACT INFORMATION :

Mother :

Father :

AUTHORIZATION OF RELEASE

I hereby authorize the following people, above the parent/guardian mentioned above, to pick up my child at the Poplar Forest lodge summer day camp in East Selkirk, MB.

1. Name

Relationship to Child :

2. Name

Relationship to Child :

3. Name

Relationship to Child :

1. Manitoba Medical # :

Name of family doctor :

2. Does your child have any serious fears ? (i.e. water,dark)

3. Does your child have any allergies ?

No Yes

Does your child carry an EpiPen for their allergies ?

No Yes

If yes, do they know how to use it ?

No Yes

Does your child need any other medication for their allergies ?

No Yes

4. Does your child have any medical conditions such as Autism, Epilepsy, Ashma, etc. that Poplar Forest Lodge should know about? The more information we have, the better the experiance we can provide.

Does your child take any medication for the above conditions?

No Yes

Does your child need to take medication during camp time?

No Yes

*NOTE: please be prepared to fill out a short Medical Release form on the first day of camp. All medications must be brought to camp in their original containers with the name of the child, medication dosage information clearly visible (a pharmacist can dispense medication into a smaller container if necessary). All medication must be left in care of the program coordinator to be dispensed according to physician's instructions.

5. Is there anything else that will help us to know your child better?

* To the best of my knowledge my child is in good health. I will notify Poplar Forest Lodge of any changes that occur in my child's health between completing this form and the start of day camp. I permit my child to participate in the full range of camp activities. I authorize Poplar Forest Lodge to authorize on my behalf all procedures including admission to hospital and treatment therein as they deem essential for the care and well-being of my child. I agree to accept financial responsibility in excess of benefits allowed by the proviancial health program and / or my medical insurance.

* I understand that pictures taken at camp may be used for promotion.

* I understand the camp policy that inappropriate or harmful behavior (to self or others) may be cause for dismissal without refund of camp fees.

PARENT/GUARDIAN SGNATURE

Date :