Summer Camp Registration

General Information

Parent's Names:

Name

Prefix First Last Suffix

Name

Prefix First Last Suffix

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Address must match credit card billing address.

Camper's address is same as billing address*

Yes
No

Camper's Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Telephone Numbers:

Home Tel:

Father's Cell Phone

Father's Email

Mother's Cell Phone

Mother's Email

Camper Profile

Name*

First Last

Birth Date*

Present Age*

Please enter a value between 0 and 30.

Name of School Camper is Attending*

Grade

Describe support currently receiving at school*

1:1
small group settings
not applicable
Other - please describe

Please describe here

Emergency Contact:

Name*

First Last

Phone*

Relationship to Camper*

Medical Information

Doctor's Name*

Doctor's Phone Number*

Diagnosis*

Please list all diagnosis

Seizures:*

Yes
No

If yes, please describe what a seizure may look like and what protocol is

Please list all prescribed medications child is currently taking*

Please List Allergies and if an Epi Pen is required*

Feeding Information (Dietary restrictions, G-tube instructions)*

List any other medical instructions/ history we should be aware of*

Please describe your child's level of independence with self care (eg. feeding and toileting)*

Describe your child's swim level*

My child needs to be held or wear a neck floater
My child is comfortable in water but can not swim
My child is in lessons and has completed level: (fill out level below)
My child has never been in a pool before

My child has completed this level in swim lessons*

Please list individual therapies your child is currently receiving on a regular basis.

Occupational Therapy
Physiotherapy
Speech and Language
Music Therapy
Behaviour Therapy (IBI)
Other

Individual Therapy Session:
We recognize the importance of continuing therapy sessions over the summer to avoid regression of acquired skills. While the camp program offers many group therapies, individual therapy sessions are available for a subsidized fee and are built into the camper's daily program.
Physiotherapy: $65
Occupational Therapy: $65
Speech Therapy: $75
Behaviour Therapy: $55

Individual therapy Sessions

I am interested in discussing this option with the camp director.

Does your child have any specific Dislikes/Fears that we should be aware of?*

Behavioral Techniques that work (ie. timer, charts)*

Other good tips to know*

Payment Information

Program	July Session July 2 - 27	July+August Session July 2 - Aug 14	Overnight Aug 14 - August 22	Full Summer July 2 - Aug 22 (daycamp+overnight)
Toddlers	$2,000	$3,200
Juniors +Peers In Play + Social Adventures + Active Adventures	$2,000	$3,200	$950 + $50 transportation fee	$4,150 + $50 transportation fee for overnight
Muscles N Motion	$2,500	$4,000	$1,150 + $50 transportation fee	$5,150 + $50 transportation fee for overnight
Teen Program	$3,000	$4,800	$1,200 + $50 transportation fee	$6,000+ $50 transportation fee for overnight

The ages of each group are a guide, if there is an older or younger child that fits well with that program it may still be the right placement for them. We can help you decide which group to enrol for.

New campers to overnight need to be approved first by the camp director. Priority will be given to returning overnight campers.

Payment Options*

I would like to pay in full online.
I would like to pay a deposit now and I would like the office to contact me to discuss payment plans.

Divisions:*

Toddlers (18m-3)
Juniors (3-6)
Social Adventures (6-10)
Muscles N Motion (5-8)
Active Adventures (4-8)
Peers In Play (6-10)
Teen Program

Please check ONLY ONE of the above

Toddlers Month:*

July
Full Summer

Juniors Month:*

July
Full Day Camp
Full Summer (if selecting this option, DO NOT check other months/overnight above)
Overnight

Social Adventures Month:*

July
Full Day Camp
Full Summer (if selecting this option, DO NOT check other months/overnight above)
Overnight

Muscles N Motion Month:*

July
Full Day Camp
Full Summer (if selecting this option, DO NOT check other months/overnight above)
Overnight

Active Adventures Month:*

July
Full Day Camp
Full Summer (if selecting this option, DO NOT check other months/overnight above)
Overnight

Peers In Play Month:*

July
Full Day Camp
Full Summer (if selecting this option, DO NOT check other months/overnight above)
Overnight

Teen Program Month:*

July
Full Day Camp
Full Summer (if selecting this option, DO NOT check other months/overnight above)
Overnight

Bussing Options

Free Depot Bussing to/from 15 Saranac Blvd
Door to Door Transportation for $10/way.

Transportation: **

I am interested in transportation for the July session mornings for $200.00.
I am interested in transportation for the July session afternoons for $200.00.
I am interested in transportation for the August session mornings for $120.00.
I am interested in transportation for the August session afternoons for $120.00.

**Bussing is available from Major Mac to Eglinton, and Avenue Road to Dufferin Street. If you are outside the route please contact us to see if it can be accommodated. Please note an additional fee may be incurred for addresses outside the route.

Pickup Address:

Drop Off Address:

Divisions*

Month*

July
Full Day Camp

Month*

July
Full Day Camp
Full Summer (if selecting this option, DO NOT check other months/overnight above)
Overnight

Month*

July
Full Day Camp
Full Summer (if selecting this option, DO NOT check other months/overnight above)
Overnight

Month*

July
Full Day Camp
Full Summer (if selecting this option, DO NOT check other months/overnight above)
Overnight

Month*

July
Full Day Camp
Full Summer (if selecting this option, DO NOT check other months/overnight above)
Overnight

Month*

July
Full Day Camp
Full Summer (if selecting this option, DO NOT check other months/overnight above)
Overnight

Month*

July
Full Day Camp
Full Summer (if selecting this option, DO NOT check other months/overnight above)
Overnight

Bussing options

Free Depot Bussing to/from 15 Saranac Blvd
Door to Door Transportation for $10/way.

Transportation

I am interested in transportation for the July session mornings for $200.
I am interested in transportation for the July session afternoons for $200.
I am interested in transportation for the August session mornings for $120.
I am interested in transportation for the August afternoons for $120.

Pickup Address

Drop Off Address

Parents Please Note:

We do not operate our own bus line. As such we have little control over the transportation mishaps but we work tirelessly to avoid them. Please consider the following before signing up for bussing: 1. We cannot ensure that there will be a monitor on the bus for the entire route. The companies we use drive for TDSB and all drivers have proper background checks and licensing. If we have a staff on the bus for part of the route, her job is to update us on arrival times and of any delays and to help the campers off the bus as they arrive at camp. Please be prepared to put your child on the bus and take them off at drop off. 2. We cannot control busses coming late, last minute driver changes, campers delaying the route and missed stops. We have a dispatcher on the phone throughout the entire route and we do our best to keep on top of delays and let parents know as soon as possible. However, from previous years we know that there will be delays and we need everyone to be patient and understanding for the first few days for sure. 3. Our route begins at Elgin Mills/ Thornhill woods and continues along Bathurst St to camp. When there is enough demand we can arrange for a bus that starts at St Clair and covers the east end pickups. If you live far east and west and you are unsure if your address is included please contact us prior to signing up for the bus service.

Total

$ 0.00 CAD

If you decide you only want to pay a partial amount or a deposit now, please go back up to the top of this section and choose a different payment option. You will have to check off your session and month again but your personal info will still be saved.

Conditions of Enrollment

1. Camp AIM’s 2018 July session begins Monday July 2nd 2018 and ends on Friday July 27th, 2018.
Camp AIM’s 2018 full day camp session begins Monday July 2nd, and ends on Thursday August 14.
2. Applications will not be processed unless accompanied by a $350 deposit per child and a signed application form. All deposit payments must be dated the date of registration. Cheques are payable to Kaylas Children Centre.
3. Campers will not be admitted to camp until the application is completed and the balance of fees are paid for the specific period.
5. While every reasonable effort is made to safeguard campers’ belonging while at camp, Camp AIM cannot be held responsible for the loss, damage or theft of any of the campers’ belongings and medical equipment/devices.
6. Seating, personal and mobility equipment, ie adaptive bikes, commodes, used by an individual camper are the responsibility of the parents to acquire (rent or bring).
7. Camp AIM cannot be held responsible for any and all claims for damages arising as a result of any accident, injury or otherwise sustained by the registered child(ren) arising from participation in any camp activities.
8. Parents agree to allow their child(ren) to participate in all camp activities, and in any supervised activities not on camp property.
9. Parents agree to give Camp AIM officials the authority to act on their behalf in case of emergency.
10. I/We have registered and submitted a $350 deposit (per child) and arranged post dated checks no later than May 1, 2018 or payment in full for the child(ren) that I/we am/are registering.
*Note: The deposit is nonrefundable for the session applied for, therefore a cancellation in any session will forfeit the deposit. 11. I/We hereby apply for registration for the herein named child(ren) for the camping services indicated in the application.

*

I agree to the terms and conditions listed above

Pictures are how we tell parents the story of camp! Please choose your options for photo release below*

My child's photos can only be viewed on the online album
My child's photos can be viewed on the online album and social media
Please do not photograph my child at camp

T-shirts*

First T-shirt is free. Each additional T-shirt is $15.00

Additional T-Shirts

Price: $ 15.00 CAD Quantity:

Payment

Total Camp Fees

This box shows you the full cost of the services you requested. You will have to pay a minimum deposit up front and the office will contact you for the rest. (This amount does not include additional therapy options)

Deposit Amount + Additional Payment

Please enter the amount of $350.00 in this field. If you would like to pay an amount above the mandatory deposit fees, add it to this amount.

Agreement*

I understand that the deposit is non-refundable.

Total Payment

$ 0.00 CAD

This total will reflect the amount you chose to pay as a deposit.

Billing Email*

Please enter the email you want to use for your billing address.

Credit Card

MasterCard

Visa

Card Number Expiration Date Security Code Cardholder Name

Captcha

Email

This field is for validation purposes and should be left unchanged.