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FAMILY Camp Registration 2022
Adult Info
Wednesday, August 10th through Sunday, August 14th
Adults $288, Kids 5 & up $168, Kids 4 & under FREE!
Preferred Arrival Date
*
MM slash DD slash YYYY
Preferred Departure Date
*
MM slash DD slash YYYY
Name
*
Address
*
Street Address
City
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Northwest Territories
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
Province
Postal Code
Home Ph #
*
Work Ph #
Cell Ph #
Email
*
Doctor’s name
*
Doctor's Phone Number
Emergency contact
*
Name
Phone
Relation
Second Emergency contact
*
Name
Phone
Relation
List medical concerns
*
List all medications
*
Allergies, or special diet
*
Where did you hear about Camp Wohelo? been before, a friend, an ad, a brochure( where did you get it?) or other (please be specific)
*
Requested cabin mates
Children’s info
Please list children with you from youngest to oldest.
First Child's Name
*
Birth date (d/m/y/)
*
Age
*
Sex
*
Doctor’s name
*
Doctor's Phone Number
Is there anyone restricted from seeing this child?
List all medical conditions, mental, emotional, physical and behavioral challenges that your child may have including, skin conditions, asthma, bed-wetting, epilepsy, diabetes, heart conditions, hyper-activity, etc.
*
List all medications
*
Allergies, or special diet
*
Date of last Tetanus shot (enter date or comment)
Second Child's Name
Birth date (d/m/y)
MM slash DD slash YYYY
Age
Sex
Doctor’s name
Doctor's Phone Number
Is there anyone restricted from seeing this child?
List all medical conditions, mental, emotional, physical and behavioral challenges that your child may have including, skin conditions, asthma, bed-wetting, epilepsy, diabetes, heart conditions, hyper-activity, etc.
List all medications
Allergies, or special diet
Date of last Tetanus shot (enter date or comment)
Third Child's Name
Birth date (d/m/y)
MM slash DD slash YYYY
Age
Sex
Doctor’s name
Doctor's Phone Number
Is there anyone restricted from seeing this child?
List all medical conditions, mental, emotional, physical and behavioral challenges that your child may have including, skin conditions, asthma, bed-wetting, epilepsy, diabetes, heart conditions, hyper-activity, etc.
List all medications
Allergies, or special diet
Date of last Tetanus shot (enter date or comment)
I give permission for my child to be photographed/videotaped for use in marketing materials
*
Yes
No
A copy of Health cards for each person must be attached to this form, or be brought with you to camp.
Accepted file types: jpg, gif, png, pdf, Max. file size: 8 MB.
All medication, prescriptions and over the counter, (OTC may include gravel, Tylenol, Benadryl, etc.) must be brought by the camper, be in the original container and given to the camp medic upon arrival at camp.
In case of medical emergency I hereby give permission to the physician selected by the camp staff to hospitalize and/or secure treatment for myself and/or my child/children as named above. I understand that in an emergency myself and/or my child/children may be transported in a personal vehicle and I hereby waive our rights and the rights of my child/ren to any claim against Camp Wohelo, it’s employees or volunteers.
*
Yes
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