2017 Galiano Application Form
Please read this entire page very carefully before completing the application form.

If you need ASSISTANCE filling out form (we can fill it out for you) - contact the GRG Support Line 1-855-474-9777 (toll free) or email grgline@parentsupportbc.ca or call Jane at 1877-345-9777 ext 110.

The application deadline is midnight on Sunday, June 4th. Applications will be considered in the order in which they are received, but we will also be considering other factors to ensure that we can invite as many families as possible from across the province, and with diverse needs and experiences.

Please scroll to the bottom of the page to go to the next section and press submit on the last page. Otherwise, we will not receive your application.

You will need to complete all the required sections (marked with a red asterisk*) to proceed to the next page.

If you are unable to proceed, please go back and check to make sure that all the necessary questions are filled out.

By completing this form, you are confirming that your have the legal authority to bring your child or children to Galiano. If you do not, please contact our office at 1-877-345-9777 so we can send you a separate waiver to fill out.

This information will be maintained confidentially by the Galiano Conservancy Association and by the Parent Support Services Society of BC. It will only be shared with Galiano Conservancy Association and Parent Support Services representatives who need to know this information in order to maintain safety and well-being of all participants. If there is other information that you consider pertinent to your child's well-being at the Nature Camp, please inform us at galianotrip@parentsupportbc.ca.

Learn more about Parent Support Services Society of BC http://parentsupportbc.ca
Learn more about the Galiano Conservancy http://galianoconservancy.ca

Photo and Media Release

We will be asking caregivers to sign a photo and media release for themselves and their children at the beginning of the trip, but are including the text of the release below so that you can be familiar with the contents ahead of time. If you have any questions about this release, don't hesitate to contact us at galianotrip@parentsupportbc.ca

Text of the release:

We take the privacy of children and youth very seriously. We are often in a position of seeking funding to provide programs like the camp and regularly in need of photographs for our website or for presentations and grant applications. We would like you permission to be able to feature the pictures taken at the Nature Camp on our websites and other materials.

Parent Support Services Society and the Galiano Conservancy does not share personal information or sell images we gather in the course of our work. In consenting to this, you grant to Parent Support Services Society of BC and the Galiano Conservancy Association, its representatives and employees the right to take and use photographs/film footage of you and your family with or without your name and for any lawful purpose, including for example such purposes as publicity, illustration, advertising, and Web content. By consenting, you authorize Parent Support Services Society of BC and the Galiano Conservancy Association, its assigns and transferees to copyright, use and publish the same in print and/or electronically.)

I have read and understood the above.
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