GRAND BAY-WESTFIELD SURVIVAL CAMP REGISTRATION 2019
Please fill this page out completely and submit, then (& ONLY THEN) click on the link under the registration form for payment. Fill out separate forms for each child attending.

Camp cost:

$160 per camper.

Week 1 & 6: Reduced rate $140 for short week

Please fill out all of the camp registration information below. You will find an online payment button below the form. You do not need a PayPal account to purchase with credit card.


Counselor in Training (CIT) Program (Grade 6-9):

Being a CIT is an opportunity for campers entering grades 6-9 to learn leadership skills and stay connected to the camp they grew up with. Being a CIT has lots of perks. Your own training session (mandatory), canteen (2 Items per day), CIT t-shirt and the opportunity to work with the staff in the planning and organizing of camp. Becoming a CIT is a pretty big deal! Spaces are limited. Max 5 CIT's per week and you need to register for your weeks prior to camp starting.

To register as a CIT please contact jennifer.fulton@sjclub.ca

$100.00 for training and 1 camp week as a CIT.
$100.00 per additional CIT week registered.
Maximum of 5 CITs per week.
Minimum CIT age: entering Grade 6 in the fall of any given camp year.

Campers Full Name *
Your answer
Parent's Name(s) *
Your answer
Parent's Phone #'s *
Your answer
Parent's Email(s) *
Your answer
List any allergies the camper has: *
Type "none" if they have none.
Your answer
List any medical conditions the camper has: *
Type "none" if they have none.
Your answer
List any medications the camper takes regularly: *
Type "none" if they have none.
Your answer
T-Shirt Size
WAIT LIST IF CAMP DATES UNAVAILABLE
K-5 Camp Dates 2019 (Check Box Next To Date or Dates)
CIT - Grade 6-9 Camp Dates 2019 (Check Box Next To Date or Dates)
FILL OUT THIS QUESTION IF AND ONLY IF YOU HAVE BEEN CONTACTED BY US FROM THE WAIT LIST: Enter the camp dates we gave you below:
Your answer
Camper's Date Of Birth (yyyy/mm/dd) *
Your answer
Gender *
List of Siblings Attending
Your answer
Street *
Your answer
City/Town *
Your answer
Province *
Your answer
Postal Code *
Your answer
Emergency Contact Name *
Your answer
Emergency Contact Phone *
Your answer
Medicare # & Expiry Date *
Your answer
Waiver of Liability
In consideration of acceptance of this application into the Boys & Girls Club of Saint John, Inc.GBW Survival Camp, I (we) the parent/legal guardian of the child listed above, our heirs, executors, administrators, successors and assigns waive and release any and all rights and claims for damages we have or may have against The Boys & Girls Club of Saint John, Inc., volunteers, directors, agents or their representatives, successors and assigns for any and all injuries, accidents, mishaps or illness which may directly or indirectly result from any participation in the program offered by the said Club and activities associated with those programs as determined in the sole discretion of the Club.
*
Required
Photo Release Consent
· I attest that I am a parent or legal guardian of the child listed above. I hereby authorize the Boys & Girls Club of Saint John to publish the photographs taken of my child for use in the Boys & Girls Club of Saint John’s promotional purposes. (Example: Website, Facebook page, Annual Report etc.)
· I release the Boys & Girls Club of Saint John from any expectation of confidentiality for the undersigned minor children and myself and attest that I have the authority to authorize the Boys & Girls of Saint John to use the photographs.
· I acknowledge that since participation in publications and websites produced by the Boys & Girls Club of Saint John is voluntary, neither the minor children nor I will receive financial compensation.
· I further agree that participation in any publication and website produced by the Boys & Girls Club of Saint John confers no rights of ownership whatsoever. I release the Boys and Girls Club of Saint John, its board of directors and its employees from liability for any claims by me or any third party in connection with the participation of the undersigned minor children.
*
Required
** IMPORTANT PAYMENT DETAILS: (Do Not Pay If You Are On The Wait List Unless We Directed You To)
* To confirm your spot, we need to receive payment in full, so please take care of that right away to avoid disappointment should your chosen week be filled before you pay! Submit this form first by hitting submit below, then you will need to go to http://kidssummercamp.ca/payment. You will be directed to a message that contains this link when you hit submit. Once you go to that page, just hit the GBW Payment link and you will be directed to the payment form. We're looking forward to seeing you/your children at camp!
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