Winnipeg River Recreation Summer Camps 2021: Registration Form
Please fill out one form per child
Participants Name: *
Date of Birth *
Family Physician *
Medical Numbers - Family (6-digit) *
Medical Numbers - PHIN (9-digit) *
Allergies/Other Medical Concerns *
Parent/Guardian Name(s) *
Cell Phone Number *
Daytime Phone Number *
Email Address *
Mailing Address *
Home Address *
Emergency Contact Person *
Relationship to Participant *
Emergency Contact Phone Number *
Check off the days you are registering for
Registration Fees: Full Week: $110 4-Days/Week: $95 3-Days/Week: $75 2-Days/Week: $55 Single Days: $30/day
Full Week
Week 1: July 7-9 (no camp July 5+6)
Week 2: July 12-16
Week 3: July 19-23
Week 4: July 26-30
Week 5: August 3-6(no camp Aug 2)
Week 6: August 9-13
Week 7: August 16-20
Camp Information
All camps are for ages 5-11 years
Camps run 9am-4pm
Early Drop off 8:30am
Late Pick up 4:30pm
Camps will be held at the Lac du Bonnet Arena
Campers must bring their own lunch- Two snacks will be provided

*Typical camp day includes a variety of different activities including organized games, arts and crafts, free play and outdoor activities (weather permitting)*
Payment Information
Payments can be made by:
-cheques made out to WRRD
-e-transfer sent to

Winnipeg River Recreation
55B McArthur Avenue
Box 852
Lac du Bonnet, MB R0E 1A0
Photographs *
I, the parent or guardian, agree that any photographs taken by Camp Staff or Campers may be used on Winnipeg River Recreations Facebook page or in the future advertisement or promotion of the Winnipeg River Recreation Summer Camp Program
Waiver Form & Camp Info: *
By signing my name below, I the parent or guardian, hereby release waive and forever discharge Winnipeg River Recreation and their employees of and from all claims arising from participation in any activity unless such injury, loss or damage is caused by the sole negligence of the Summer Camp Program; or its employees while acting within the scope of their duties. Winnipeg River Recreation is not responsible for children registered in the Summer Camp Program before the hours of 9am and after the hours of 4pm.
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