Est. 2000 LANARK ADVENTURE DAY CAMP SPONSORED BY LANARK BAPTIST CHURCH REGISTRATION Children Ages 5 - 12 Get to Know us! You'll be glad you did!

LOCATED AT PROVIDENCE POINT, 67 PAUL DRIVE, LANARK ON 2 MINUTES FROM MAPLE GROVE PUBLIC SCHOOL.

From the Lanark Adventure Day Camp Committee:

Dear Parent or Guardian;
Thank you for your interest in the Lanark Adventure Day Camp, sponsored by Lanark Baptist Church, and held at Providence Point Retreat Centre in beautiful Lanark. This camp is part of the leadership development vision for the children of Lanark County and open to all children regardless of religious affiliation.

A variety of activities, including outdoor sports, field games, singing, crafts, swimming, moral character education, and Bible stories will be available to your children.  Your child will be supervised at all times while at Lanark Adventure Day Camp.

Registration Forms should be filled out ASAP and returned to:
    Lanark Adventure Day Camp
    c/o Rebekah Smith
    5 Clyde St
    Perth ON K7H 2T5

If you have any questions, please contact Rebekah Smith at:  613-267-3776 or autoum21@hotmail.com

Please read, fill out and return the Registration Forms below:
•    General Information
•    Terms & Conditions
•    Application form & Attendance Requests
•    Liability & Release forms
•    Include your Registration fee(s)


We look forward to having your child/children at Lanark Adventure Day Camp this summer!
    Lanark Adventure Day Camp Committee: Pastor John McIntyre,
    Karen McIntyre, Linda Lalonde, Verna Morrice and Brandi McDonald.

Registration
General Information

Hours Location
Monday – Friday: 8:00 am to 4:30pm          Providence Point Retreat Centre
Drop-off between 8:00 am and 8:30am        67 Paul Drive, Lanark, Ontario
Pick-up between 4:00 pm and 4:30pm        (just off Hwy 511 [the old Lanark Road])

Fees
Fees are $20.00 per day.  Payment for each week must be received at the first of the week.  
A registration fee of $50.00 must accompany the Registration for Lanark Adventure Day Camp.  This fee will be applied to your child’s first days at camp.
* A 24-hour notice needs to be given the Director if your child is registered for a specific day and the child cannot attend. Please note that the failure to notify the Director means you will be required to pay the daily fee.  In order for us to provide a quality camp experience for your child, at such a low cost we need all our spaces to be filled. Thank you.

Cheques are to be made payable to: Lanark Baptist Church. One tax receipt per household will be issued at the end of the year.  

Drop-Off and Pick Up of Children
•    Parents are responsible for transporting their children to and from Lanark Adventure Day Camp. 
Punctuality is essential in this matter.  Our staff is only paid until 4:30.  If they are required to stay after 4:30 with your child we ask that you reimburse them for their time @ a rate of $5.00 per child for 1-15 minutes after 4:30 and $10.00 after 15 minutes. Please understand that repeated tardiness could forfeit your child’s ability to stay at the camp.
•    Children will only be released to the people on the release form and the parents.  If a person who is not on the release form is to pick up the child please send a note with the child, as we need this information in writing in order to protect the child.
•    Providence Point asks that you abide by the posted speed limits, for your child’s safety.

Providing a Safe & Healthy Summer Camp requires a play safe & healthy child
•    Sick: Please do not send your children to camp if they are sick e.g. flu, cold etc. Others may contract the illness or your own child may become worse. If your child is not able to participate in the planned activities, then he/she should not attend camp.  Please alert the Director at 613- 267-3776 or 613-812-1805 ASAP
•    Disruptive: It is up to the discretion of the Director if a child can remain at Lanark Adventure Day Camp. Consistent behavioural problems could forfeit your child’s ability to stay at the camp. Parents may even be asked to pick up their child immediately should the child continue to be disruptive throughout the day. The Lanark Adventure Day Camp will refund your money on remaining days.
•    Discipline: Discipline is the process by which adults help children develop self-control. Behaviour management techniques such as monitored “time outs” and time for individual discussion that reinforces positive or acceptable behaviour will be used.  Terms & Conditions will be discussed with the children as required.  The Lanark Adventure Day Camp Committee reserves the right to suspend a child for behaviour or language the Committee deems to be inappropriate.

Emergency Information Forms
These forms are absolutely necessary and must be kept up to date for the summer.  We will always contact you first and then your emergency contact person.  The Director will contact you if your child is sick or has questions concerning your child.  All information contained in the forms will only be viewed by the Director and counsellors on a need to know basis.

Lunch and Snacks
Hot lunch and snacks will be provided for your child.  It is the responsibility of the parent/guardian to let us know in writing of any food allergies that your child may have.  Due to the fact Providence Point is open to other visitors during the summer we cannot guarantee a peanut free environment.

Items to Pack for Camp
Sunscreen, towel, swimsuit, hat, sweater, running shoes
Optional: personal lifejacket, change of clothes
Please label all belongings.

Terms & Conditions

1.    Aggression such as pushing, kicking, shoving, spitting etc. will not be tolerated.  If your child is experiencing a problem with another        camper, you and/or your child must seek out the Director for resolution of the problem.

2.    Aggression such as swearing, yelling, or name-calling will not be tolerated.

3.    People’s property is to be respected. This includes campers’ belongings and our hosts’ property at Providence Point.

4.    Permission must be received from a counsellor before leaving their direct supervision for any reason.

5.    Respect persons and do not enter unauthorized areas.

Application Form

Please fill in and make sure this information is kept up to date. All information is confidential.
CHILD’S NAME ________________________________________________________
PARENTS NAME(S) _____________________________________________________
HOME ADDRESS OF CHILD______________________________________________
PHONE (H) _____________________ (W/C) _________________________________
CHILD’S AGE ________________________DATE OF BIRTH  ___________________
HEALTH INSURANCE NUMBER  _________________________________________
MEDICAL CONDITIONS  ________________________________________________
_______________________________________________________________________
FAMILY DOCTOR NAME AND PHONE  ___________________________________
FOOD ALLERGIES  _____________________________________________________

FULL INFORMATION – PARENTS
MOTHER ______________________________________________________________
ADDRESS  _____________________________________________________________
HOME PHONE  _________________________________________________________
WORK PHONE  _________________________________________________________
FATHER  _______________________________________________________________
ADDRESS  _____________________________________________________________
HOME PHONE  _________________________________________________________
WORK PHONE  _________________________________________________________
EMERGENCY CONTACT PERSON  
This person must be available and able to pick up your child/children in the event that you are unable to.
NAME  _________________________________________________________________
PHONE  ________________________________________________________________
Is there anything else regarding your child/children you feel is relevant and important for day camp staff to know?
________________________________________________________________________
________________________________________________________________________

ATTENDANCE REQUEST

Please fill in the chart below to the best of your knowledge, checking off the number of days your child/children will be attending Lanark Adventure Day Camp. This may be amended as necessary.

Month	Monday	Tuesday	Wednesday	Thursday	Friday
June 29 –July 3	29	30	July 1st Holiday No camp	2	3
July 6 –10	6	7	8	9	10
July 13 – 17	13	14	15	16	17
July 20 –24	20	21	22	23	24
July 27 –31	27	28	29	30	31
Aug. 4–7	3 Holiday No camp	4	5	6	7
*Aug. 10 –14	10	11	12	13	14
Aug. 17 –21	17	18	19	20	21 Last Day of Camp

*Please Note: August 10 – 14

During the week of August 10 – 14 the facility at Providence Point Retreat Centre is not available to us. During this week, Lanark Adventure Day Camp will be held at Lanark Baptist Church located at 77 York St. Lanark and we will be swimming at the Lanark Beach with our qualified lifeguard.  We will also be playing field games at the Lanark Ball Diamond.

Registration Fee of $50.00 is attached        Y/N
If no, please explain: __________________________________________

This fee will be applied to my child’s first days at Lanark Adventure Day Camp.

Liability Form

Child’s Name: ___________________________________

I  _______________________________________ THE RELEASOR (parent/guardian), will not hold the RELEASEES (Providence Point Retreat Centre, Lanark Baptist Church, Lanark Adventure Day Camp Committee Members and Staff) for any injury which may occur during my child’s attendance at Lanark Adventure Day Camp.

THE RELEASOR, does hereby release, acquit, remise and forever discharge the RELEASEES from any and all actions, causes of action, suits, proceedings, claims and demands, and negligence, whatsoever, including those suffered by the child(ren) attending the Lanark Adventure Day Camp.

The RELEASOR accepts the full responsibility that their child(ren) attend the Lanark Adventure Day Camp and included are activities with other children such as organized sports, swimming, crafts and hiking. The children will not be left alone and all children are subject to the Terms & Conditions of attending Lanark Adventure Day Camp. The RELEASEES will practice due diligence for the safety and protection of the children.
The RELEASOR further agrees and undertakes to indemnify and save harmless the RELEASEES from any and all actions, causes of action, suits, claims, and demands whatsoever which have been, are being, or may be made or asserted by or on behalf of any person entitled to claim under the Family Law Act, Health and Safety Act or similar legislation, arising out of the matters referred to in the above.

Signed by the Releasor (parent/guardian),

_______________________________

I ACKNOWLEDGE that I have been given the opportunity to review this waiver prior to the time of agreeing to sign it. I have signed it of my own free will and without any form of duress being exerted upon me by the RELEASEES or anyone acting on their behalf.

DATE __________________________
In the presence of:           
_______________________________  
Witness Signature                                        
________________________________
Print name of Witness

RELEASE FORM

PERMISSION FOR PICK-UP other than parent/guardian
I  ________________________________ authorize the following person(s) to pick up my children from Lanark Adventure Day Camp:
     (Parent/Guardian)

__________________________________________ Phone  _______________________

__________________________________________ Phone  _______________________

__________________________________________
                                (Parent’s signature)

PERMISSION FOR SWIMMING

I  _____________________________________________ give permission for my child
    (Parent’s name)
 _______________________________________________ to go swimming at Lanark
    (Child’s name)
Adventure Day Camp at Providence Point (and the Lanark Beach Aug. 10-14).
______________________________ Swimming Level Achieved  ______________
(Parent’s signature)

Life Jacket Needed: (Please circle) Yes  /  No  /  when he/she can’t touch the bottom

PERMISSION FOR ADVERTISING PHOTOGRAPHS

I  ____________________________________ give permission for my child
(Parent’s name)
______________________________’s photograph to be used in order to promote Lanark Adventure Day Camp.
(Child’s name)

  _______________________________________________
(Parent’s signature)

Thank you for joining us at Lanark Adventure Day Camp!