2018 Ancaster Fair Camp Registration
Ancaster Fair Camp brings a new and exciting twist to the traditional day camp. Our qualified, trained, and screened staff, offer a fun filled camper focused environment for campers who are 5-13 years of age on January 1st, 2018. Physical activity through sports and games, environment / agriculture awareness and exploration, arts and craft projects, baking, life skills, and regular camp fun will all be offered at this community based environment. Through age appropriate hands on learning experiences, our campers will learn what the Ancaster Fair and Camp are all about.
Some offered activities will include: hands on with different farm animals, planting seeds and flowers, baking cookies, bird watching and bug/frog hunting while exploring our environment, large and small group games, crafts and art projects that they can be entered in the fair, sports, hiking, scavenger hunt, obstacle course, water games, drama, songs, and they will meet a community helper. Check the website for a complete list of possible activities.
Campers will get: a camp t-shirt, a one year Ancaster Fair membership/pass and exhibitor number, a camp photo, projects to make, keep and enter in the fair, hands on animal interaction, and 5 days of summer fun.
Email address *
Camp Session Choice *
Drop Off: 8:30am - 9am, Pick up: 4:30pm - 5pm. Extended care option available. All fees include a $50 non-refundable deposit. All weeks are $250 + hst.
Select week: *
Required
Parent/Guardian Information
Primary Contact First Name *
Your answer
Primary Contact Last Name *
Your answer
Relation to Camper *
Your answer
Gender
Email *
Your answer
Home Phone *
Your answer
Work Phone
Your answer
Address *
Your answer
Postal Code *
Your answer
Secondary Contact First Name
Your answer
Secondary Contact Last Name
Your answer
Relation to Camper
Your answer
Home/Cell/Work Phone
Your answer
Address
Your answer
Postal Code
Your answer
Camper Information
Camper's Legal Name (First) *
Your answer
Camper's Legal Name (Last) *
Your answer
Birth Date *
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DD
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YYYY
Age *
Your answer
Grade *
Your answer
Gender *
T-Shirt Size *
Previous Camp Experience
Your answer
Home Address *
Your answer
Postal Code *
Your answer
Emergency Contact *
Your answer
Emergency Contact Phone Number *
Your answer
HEALTH HISTORY AND PERSONAL INFORMATION
The more information you can provide, the better we can meet the needs of your child. This information will be used by camp director, and your child’s counselor. If there is additional information of a sensitive nature, please feel free to send a separate letter marked confidential, to the Program Manager. All information is treated confidentially and respectfully. We encourage, but do not require a medical examination or check up before camp.

Please check appropriate box and answer all questions.

Is the participant under any form of treatment or medication for an illness, condition or disease? *
If Yes, please describe
Your answer
Does the participant have any physical or mental symptoms that will affect participation?
If Yes, please describe
Your answer
ALLERGIES
Please check all that apply
If you checked off any allergies, please list any specifics
Your answer
Carries Epi-pen?
If yes, please describe what for
Your answer
Wears medical-Alert Bracelet?
If yes, please describe what for
Your answer
Dietary Needs
Please check all that apply
Vaccination
What is the approxiamate date of your child's last booster shot?
MM
/
DD
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YYYY
Other Health Issues
Please check all that apply
Medical Information
Doctor's Name
Your answer
Doctor's Phone
Your answer
Doctor's Address
Your answer
Health Card Number
Your answer
Version Code
Your answer
PHOTO AND VIDEO CONSENT ASSIGNMENT AND RELEASE POLICIES
Purpose: For marketing, advertising, promotional and/or communication purposes, Ancaster Fair Camp may, from time to time, take photographs and/or video recordings of Camp activities and events. We will be sending campers home with a photo of their camp group at the end of the week. Some of these photos may go on the website, to show activities and photos of camp in progress.

By signing this form you are giving us permission to take photos and video clips of your child at camp and granting us the right to use them for Camp promotional and advertising purposes, as well as to go home with the campers.

I hereby agree to allow photographs and video clips to be taken of my child, whether posed or candid, while on Ancaster Fair property or while participating in camp activities, trips or events, to be reproduced, published, displayed, broadcasted, transmitted, licensed, or otherwise used for the intended purposes. I hereby assign to Ancaster Fair any and all rights, including copyright, financial or other rights, to the photographs or videos they produce. I acknowledge that I have no rights financial or otherwise to these photographs or videos and grant all ownership and rights to the Ancaster Fair.

I grant this permission on the grounds that anything produced will not contain: defamatory, harmful or inappropriate material, or violate any privacy or moral rights.

I confirm I am over the age of majority in my province, I am competent to execute this form, and I have legal signing right for the registered child on this form.

I give Ancaster Fair Camp permission to take photographs of my camper to be used as a visual record of activities, and to be used on future promotional items, ( brochure, advertisement) and for purposes designated by the Ancaster Fair.

By submitting this form, you are granting consent to the Ancaster Fair Camp

REGISTRATION POLICIES
Payment: Full payment and registrations are due by June 1st. Payment is due with Registration. We cannot hold any positions until full payment is received.

Extended Care: Early/After hour care is available to those who need it. Please contact the fair office to make these arrangements as it is on a first come first serve basis. There is an extra fee for the extended care. Early drop off and/or late pick up is $20 each ½ hour prior to 8:30am or after 5pm and must be reserved before camp sessions begin.

Registration Information Package: A camper package will be emailed to each family upon acceptance of the registration form and payment.

Refusals: Ancaster Fair reserves the right to refuse registration based on misconduct, previous behaviour at camp, or lack of resources to meet a camper’s medical or special needs. If this occurs, a full refund will be issued.

Campers with Special Needs: Campers with special developmental and/or physical needs are asked to process there registration through the Fair office at (905)648-6198. We cannot guarantee accommodation and process each request on an individual basis. Support worker or care giver may attend camp with child if approved.

Session Cancellation: Ancaster Fair reserves the right to cancel any session if a minimum number of campers have not registered up to two week prior to the start of session. If this occurs, full refunds will be issued.

REFUND POLICIES
Refund Requests: Must be submitted in writing to the Camp Manager at least 1 month prior to the start of your camp session in order for refunds to be issued ( this will not include the non-refundable deposit of $50 )

Medical Reasons: A refund will be issued for any medical reason only when the letter is accompanied by a written medical note from a doctor but will not include the $50 non-refundable deposit.

Withdrawal, Misconduct, Homesickness, or Head Lice: Refunds are not granted if the parent and/or guardian withdraw the camper from a session early or if the camper is sent home due to misconduct or head lice. In the event of a withdrawal request less than one month prior to the camp session, refunds will be issued (less the $50 deposit) only if the camp registrar is able to fill the camper’s spot.

CODE OF CONDUCT
The safety of each individual in the program is of the utmost importance. Each registrant must recognize a personal responsibility to learn and follow at all times the safety and other rules established by Ancaster Fair Camp staff. I hereby agree that any behaviour of the registrant that places him/her or others at risk may result in the registrant’s immediate dismissal from the program. Further, if dismissed from the program, I agree to cover any expense(s) arising from such dismissal.

I hereby acknowledge and agree that no refund will be granted for dismissal or removal of the registrant at his/her request before the end of a program session. In order to ensure the safety and well-being of all individuals participating in the program, we reserve the right to alter the program at any time without notice or compensation to the registrant.

By submitting this form, you are agreeing to have read and understood the code of conduct.

ASSUMPTION OF RISK AND INDEMNIFYING RELEASE
While Ancaster Fair Camp staff, volunteers and instructors will make every reasonable effort to minimize exposure to known risks associated with registrant’s participation in a camp program, I hereby acknowledge that I and or my child if I am registering on his behalf may be required to participate in various physical activity or activity that may result in physical injury. In this regard, I agree I have provided a complete and accurate health history and hereby permit the registrant to participate in the full range of Program activities, except as specifically noted by me in the health history of this registration form. In consideration for the registrant’s opportunity to participate in this program, the receipt and sufficiency of which is hereby acknowledged, I hereby release and forever discharge Ancaster Fair of Ancaster Ontario, its representatives, officers, directors, employees, volunteers and agents, and their respective successors and assigns, from any and all liability for damages sustained in consequence of loss, injury or damage to the registrant, and from all other actions, causes of action, claims, demands or damages of any kind with respect to death, injury, loss, or damages to any person or property arising out of, or connected with preparation for, or participation in, the camp program.
MEDICAL EMERGENCIES
In the event of an accident, injury or illness involving the registrant, and immediate contact by Ancaster Fair Camp with a designated contact cannot be made, I hereby authorize and grant permission to Ancaster Fair Camp Staff to secure proper medical treatment and authorize on the registrant’s behalf all procedures, including, without limitation, admission to an emergency unit, hospital and treatment therein, ordering of x-rays, tests or treatment, injections, anesthesia and/or surgery, as deemed necessary by the attending medical professional(s). By submitting this form, you agree not to hold the Ancaster Fair responsible for any costs or injury arising out of an emergency situation.
COMMITMENT TO PRIVACY
The Ancaster Fair Camp is committed to protecting personal information by following responsible information handling practices. We collect and use information you volunteer when you access or register for our camp program, in order to better meet your service needs, to ensure a safe environment, for statistical and assessment purposes, to inform you about the program in which you are registered, and to satisfy government and regulatory requirements. You may also hear from us periodically about other opportunities and upcoming events at the fair that may be of interest and of benefit to you. For more information go to our website, www.ancasterfair.ca or call the fair office at (905)648-6198.
DISCLAIMER - PLEASE NOTE:
All programs are subject to change or cancellation due to low enrollment or other unforeseen circumstances that prohibit operation of program. As we are public site we cannot guarantee an allergen free environment. We ask that no peanut products are brought in lunches but we cannot be responsible for what other campers pack, or be sure that the equipment, buildings and/ or any item they touch has not come in contact with an allergen. Registration is at your own risk.
RETURNING CAMPER REFFERALS
Ancaster Fair Camp is offering $25 off your registration fee if you refer a friend and they complete a week at camp. You can save up to $75 off your camp fees. Does not apply to siblings and you will get the discount after the completed week of camp.
We are referring the following people (please list)
Your answer
I was referred to camp by (please provide name)
Your answer
CAMPER PACKAGES AND INFORMATION
It is our practice to send camper packages and other correspondence by EMAIL.
Please check here if it is possible for you to receive our camper package and other information electronically. *
AUTHORIZATION
In registering my child to camp at the Ancaster Fair, I (the undersigned parent or guardian or other authorized party) hereby agree as follows:
I understand that my child is expected to participate fully in the program and all camp activities *
Required
I understand that the Camp Manager reserves the right to dismiss a camper who, in his/her opinion, is a detriment to the safety, enjoyment, or rights of others, or who appears to not be benefiting from the camp experience *
Required
I understand that the Camp Manager reserves the right to dismiss a camper who, in his/her opinion, is a detriment to the safety, enjoyment, or rights of others, or who appears to not be benefiting from the camp experience *
Required
I understand that if there is any exposure to any infectious disease and/or any change to my child’s condition prior to or during attending camp, I will notify the camp in writing. □ I have read and understand the registration, photo and video consent and release, code of conduct, the assumption of risk, medical emergency release, commitment to privacy, disclaimer, refund policies, and trip consent and release as listed above, and my payment options. * *
Required
PAYMENT OPTIONS
1. One Cheque – One payment by cheque covering the full payment and is payable with the submitted registration form. Please make cheques payable to Ancaster Fair.

If choosing this option, please send cheque to:

ANCASTER FAIR
630 Trinity Road South, Ancaster, Ontario. L0R 1R0

2. Credit Card – After submitting this form, complete Step 2 of registration on the Ancaster Fair Webpage here: http://ancasterfair.ca/summer-camp/registration/

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