Howe Middle Music Retreat 2018 Registration
Completing and submitting this form will confirm your child's participation in our music retreat June 6-8, 2018.
* Required
Child name (last, first):
*
Your answer
Grade:
*
Your answer
Classroom teacher (last name only):
*
Your answer
Parent name(s):
*
Your answer
Parent email:
Your answer
Parent phone number (222-333-4444):
*
Your answer
I am aware that the Howe Music Retreat will be taking place June 6 - 8, 2018, at Timberline Ranch in Maple Ridge, BC, and would like my child to participate.
*
Yes
No
I am aware that the cost to participate in the retreat is $200, and agree to pay before May 15th, 2018
*
Yes
No
Please check all dietary restrictions that apply to you:
*
None
Vegetarian
Other
Other:
Required
If you checked 'Other' in the previous question, please describe below:
Your answer
Please list any food-specific allergies your child has:
Your answer
Please list any medications that your child takes as part of a prescription schedule mandated by a doctor, or in case of allergic emergency (for example, EPI-pen):
*
Your answer
I agree to equip my child with all items they will need for the retreat as detailed in the "Items to Bring" list that will be provided. I will discuss any special circumstances with Mr. Noftle prior to the retreat.
Yes
No
I want my child to participate in supervised horseback riding while at the retreat.
*
Yes, I would like them to participate
No, I do NOT want them to participate
I have discussed with my child, and agree to the high standards of behaviour that will be expected for the duration of the music retreat, and am aware that behaviour issues may require me to come and get my child during the retreat to take them home, as decided by Mr. Noftle, in consultation with the parent supervisors.
Yes
No
As a parent, I am available and willing to come to the retreat to assist with child supervision. I understand this will require a police record check (please start this process immediately), and meeting with Mr. Noftle for itinerary planning and supervision training.
*
Yes
No
I might be able to come, but am working on securing my availability for June 6 - 8.
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