Childs Name: ______
Kiwanis Sunshine Point Camp
Summer 2017 Registration Application
Kiwanis Sunshine Point Camp is a seven day, overnight camp for children. It is located on Lake Erie at 955 County Road 50 East, forty-five minutes from Windsor, between Colchester and Kingsville. Our camp welcomes boys and girls over a seven week period beginning July 9, 2017. Five weeks are reserved for boys and girls ages seven to eleven. Weeks 3 and 7 are reserved for 12 – 14 year olds. Each camp period runs from noon Sunday to the following Saturday morning.
Parents can choose which week they would like their child to go to camp, and potentially who they would like their child to go with, like a brother, sister, family member or friend. However, due to age and or prior bookings, not all requests may be satisfied. Early registration is encouraged. Scheduled campers can take our bus or be driven to and from camp. The bus leaves promptly at 1:00pm Sunday from Immaculate Conception School, 465 Victoria Avenue, across from the YMCA downtown. The bus returns the following Saturday at 10:00am, at the same location. Scheduled campers who have chosen to be driven to the camp may be dropped off at the camp at 2:00pm Sunday and picked up the following Saturday at 9:00am.
Applications will be available through various community organizations, through mail, online at www.kiwanissunshinepointcamp.com and from the reception desk at Deerbrook Realty 59 Eugenie St. E. You may contact the registrar at 519-816-9979
Registration Fees – Payable in advance:
First child $275
Second child $250
Third or more: $225
Please submit with a fully completed registration form and the camper information form with your child’s name is at the top of each page. A separate form is required for each child. At Kiwanis Sunshine Point Camp we want all kids to come to camp so depending on family income financial support may be available. Please submit a financial support application should you feel you qualify.
Please note that spots are not reserved until payment has been received.
4 Convenient Methods of Payment
Money Order to the Kiwanis Club of Windsor– Mailed to address below
E-transfer to (don’t forget to send the answer to your security question)
Paypal at Kiwanissunshinepointcamp.com
Cash payment can be coordinated with Registrar
Completed Registration and Financial Support Forms
Mail to address below
OR
Scan and email to
Kiwanis Club of Windsor
535 Lypps Beach Rd.
Harrow, Ontario N0R 1G0
Kiwanis Sunshine Point Camp
Summer 2017 Registration Application
1. Please return forms as soon as possible and indicate if the camper is attending with a family member or friend. There are limited spaces available each session and we recommend early registration to ensure your child’s placement. Be sure to legibly print your child’s name at the top of each page.
2. Please submit fully completed registration forms and payment by one of our convenient methods. Personal cheques cannot be accepted under any circumstances, and spots will not be held while awaiting payment.
3. Please note fees will only be refunded in case of illness with a medical doctor’s note, or death in the immediate family. Under no other circumstances will fees be refunded, including the denial of entrance to camp due to head lice. This rule is strictly enforced.
Camp Choices: To ensure that every child has an opportunity to attend camp, applicants may apply for one week of camp. In the event you wish a second week, and we have openings, we will contact you for a second week. If you would like this option, please check the line provided and indicate which week you would prefer. (1) ______(2) ______(if space available)
Dates: (7 – 11 years only) Dates: 12 – 14 years only
Week 1: July 9-15 Week 3: July 23 - 29
Week 2: July 16 -22 Week 7: August 20 – 26
Week 4: July 30 – August 5
Week 5: August 6 – August 12
Week 6: August 13 – 19
Campers Last Name: ______Campers First Name: ______
Age: ______Gender: Female ____ Male ____ DOB: _____/_____/_____
Address: ______DD MM YY
City: ______Postal Code: ______
Parent (s) _____ Legal Guardian _____ Name: ______
Home Phone: ______Cell Phone: ______
Email Address: ______(For Emailing Confirmations)
Name of Family Member or Camper Also Attending: ______
IF YOU ARE REQUESTING FINANCIAL ASSISTANCE PLEASE INCLUDE THE APPLICATION.
Kiwanis Sunshine Point Camp
Summer 2017 Registration Application
Health Card Number: ______
Date of Last Tetanus Immunization: _____/_____/_____
Family Doctor: ______Phone: ______
(This information is important and required for completion of registrations)
Emergency Contact Numbers (Mandatory)
(Please Provide Two Emergency Contacts As Indicated)
Current Medications *MUST BE IN ORIGINAL CONTAINERS*
I hereby authorize SPC staff to administer all prescribed medications. ______
Allergies: (Please Specify) ______
Special Dietary Requirements: ______(Vegetarian, Lactose Intolerant)
Medical History
______Bed Wetting ______Epilepsy ______ADD
______Sleep walking/ Night Terrors ______ADHD ______OCD
______Heart Conditions ______Other ______
Please Note: “Drug Holidays” are not permitted at camp. If your child is on behavioural medications, we ask that you please keep them on their regime of medications for the duration of the camp (Ritalin, etc.). Also, the staff is not permitted to give injections. Campers whose medication is administered by injection must be able to self medicate.
Kiwanis Sunshine Point Camp
Summer 2017 Registration Application
I do hereby give permission for my child to receive the following at the discretion of the KSPC First Responder or Camp Director.
Acetaminophen (Tylenol): Relief of fever/pain_____ Yes _____ No
Ibuprofen (Advil): Relief of fever/pain _____ Yes _____ No
Kaopectate: Relief of upset stomach/diarrhea _____ Yes _____ No
Benadryl : Relief of allergy symptoms/hives _____ Yes _____ No
Gravol: Relief of nausea _____ Yes _____ No
Additional information regarding this child:
______
______
Transportation Information
Please check the following line: (See Attached for Information)
My child will be taking the bus to and from camp ______
My child will be driven to and from camp ______
by ______
The Kiwanis Club of Windsor Privacy Policy
All information will be kept in strict confidence as required by the privacy act. By signing the attached forms where required, you authorize the Camp staff at his/her discretion to provide all necessary information to ambulance, paramedic, hospital, doctor, nurse, police, Children's Aid Society, and all other personnel who may be involved with the treatment of your child. If you have concerns of a more confidential nature, please address these in a separate letter along with the forms.
On occasion, we take photographs of the children during camp for The Kiwanis Club of Windsor's use to promote and fundraise for the camp. Under no circumstances will we identify a child’s name.
Kiwanis Sunshine Point Camp
Summer 2017 Registration Application
Important Notice Concerning Head Lice & Campers
Head lice is a concern wherever children congregate. This does not indicate a lack of cleanliness or poor sanitation but simply contact with an infected person. We at Kiwanis Sunshine Point Camp must take every precaution to prevent an outbreak at the camp. Camp would have to be closed and all children sent home if this problem occurred during a session.
If head lice is discovered at the bus pick- up there are two immediate problems:
1. Your child is unhappy that she/he cannot attend camp.
2. Another child has been deprived of a camping experience as the now empty spot cannot be filled on such short notice.
The following guidelines for all parents will ensure happy campers.
1. Inspect your child’s hair thoroughly 3 weeks in advance of the date that they will be attending camp. Continue to inspect thoroughly for the following 2 weeks.
2. If the problem is discovered, please contact your doctor or pharmacist and follow the directions for treatment and continue to do so until the camp date arrives.
3. Immediately call the camp registrar to determine if the child should be rescheduled.
Reminder: The registration fee is not refundable if head lice stops your child from attending camp, including when no other camping space is available.
As Parent/Guardian, I warrant that to the best of my knowledge, the above-named child is in good health and has not been exposed to any infectious diseases in the previous four weeks. In the event of an emergency, I give permission to the Staff of Kiwanis Sunshine Point Camp, Doctors, Nurses, Ambulance, Emergency Room Staff and any necessary hospital staff to contact the child's doctor as listed on the medical form if required. I have read the accompanying camp information sheet, including privacy policy and accept the terms and conditions for enrolment there-in.
As Parent/Guardian, I hereby give permission to the staff of the Kiwanis Sunshine Point Camp to search my child's belongings and hold safe any knives, matches, or other items deemed at the discretion of the Staff to be unsafe or potentially harmful in any way to campers, staff or property.
______
Signature of Parent of Guardian Date
Kiwanis Sunshine Point Camp
Summer 2017 Registration Application
Important Information Regarding Transportation
Please keeps this page for reference on your child getting to and from camp.
There are two different methods you can choose for getting your child to and from camp.
FREE BUS TRANSPORTION
The bus leaves the Sunday of your week.
Where: Immaculate Conception School, 465 Victoria Avenue.
Check in Time: 12:30pm
Departure time: 1:00 pm – Promptly!
The bus returns with the children the following Saturday.
Where: Immaculate Conception School, 465 Victoria Avenue.
Parent Arrival: 9:45am
Pickup Time: 10:00am
Please be on time. If you are not present to pick up your children we have no choice but to contact authorities.
PARENT SUPPLIED TRANSPORTAION
On Sunday drop the children off at
Where: Kiwanis Sunshine Point Camp, 955 County Rd 50. E, Harrow On.
Time: 2:00 pm – Please do not arrive before this time
On the following Saturday pickup the children at:
Where: Kiwanis Sunshine Point Camp
Time: 9 am – Please be prompt as all children including bussed children leave at this time.