Lighthouse Camp Registration
Welcome to Lighthouse Kids! Summer Day Camp Registration. Please complete a separate form for EACH child in your family that will be attending. Early Registration Rates are $75/child/week for each of the first two children in the immediate family for full weeks; $40/week for the 3rd child in immediate family, any other children are free (maximum family rate is $190/week full weeks). Partial weeks (First week of July and August is $60/child/week for each of the first two in immediate family; $30/week for 3rd child, any other children are free (maximum family rate is $150/week). To receive EARLY REGISTRATION RATES, registration and payment MUST BE RECEIVED BY JUNE 15, 2019. Any registrations/payment received after that date are at the REGULAR RATES. $125/week/child for the 1st two in an immediate family, $65/third child, any other in immediate family free - maximum family registration rate of $315 for full weeks; $100/week/child for each of the first two in immediate family; $50/week for third child, any others in immediate family free for partial weeks (1st weeks of July and August).

Children in Grade 7 and 8 are eligible to participate in our Junior Assistant Stream of camp. Those participating in this stream will enjoy all the activities and benefits of camp, in addition to pre camp training and leadership opportunities daily. These participants will still be considered campers and will remain under the authority of camp staff.

Child's Name *
Your answer
Parent(s) Name *
Your answer
Email *
Your answer
Complete Address *
Your answer
Phone Number (you can be reached at during camp hours. *
Your answer
Please list any allergies and/or medical conditions *
Your answer
Child's Birthdate *
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School Attended
Your answer
Grade child will be entering in SEPT, 2019 *
Tshirt Size *
Weeks Attending *
Required
Will child require early drop off/late pick up? Cost is $8/child/day OR $15/family/day for either or both options. These fees are not payable until the week of camp needed. *
Anything else you would like us to know?
Your answer
By checking the box I agree that in registering my child for this Day Camp I hereby release LIGHTHOUSE CHURCH and all camp and LIGHTHOUSE staff of all liability for damages or injuries sustained by my child while participating in this activity and all camp activities including all field trips. In consideration of my child’s participation in this activity, I agree that my child’s likeness may be photographed or videotaped and that such image may be published in any outlet used to promote or publicize the activity. In the event of an emergency, I hereby give permission to LIGHTHOUSE and DAY CAMP staff to seek emergency medical attention as needed, up to and including hospitalization to provide necessary treatment for my child, as named above. I acknowledge that LIGHTHOUSE and its agents cannot assume liability for injury on the way to or from camp field trips and/ or during camp activities and supervision. It is understood that an agent of LIGHTHOUSE or other authority will try to contact me at the contact that I provided on this camp registration form in the event of an emergency. By checking the box above, as parent and natural guardian or legal guardian does hereby represent that he/she is, in fact, acting in such capacity and agrees to the extent permitted by law to save and hold harmless and indemnify each and all of aforementioned parties from all liability, loss, cost, claim or damage whatsoever which may be imposed upon or incurred by said parties because of the participation of the minor in the activity shown, and release said parties in this regard on behalf of both the minor and the parents or legal guardian as well. *
Required
Once you complete the registration, please arrange payment. This can be done via paypal on the website, a cheque can be mailed in to: Lighthouse Day Camp, 266 King St., Amherstburg, ON N9V4C6 or you may email: lhkids1@hotmail.com to arrange an appointment to come in (or call in) to pay debit or credit. Your registration cannot be guaranteed until payment has been received. *
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