Experience Summer Camp 2025
Camp runs in one-week long sessions starting June 30th and running throughout July and August.  All children in North Hastings are welcome to attend if they turned the age of 5 by Dec. 31, 2024 through to the age of 12 (as of Dec. 31, 2025). 

Once this registration is submitted, a team member will confirm via email the registered week that campers will be assigned to. This email will have more details regarding camp programming, expectations and waivers to be completed prior to attendance. 

We are so excited and can't wait to see our campers this summer! 

If you have an outstanding balance with NHCS the balance will need to be paid prior to registering for ESC.  Please contact the office at office@nhcs.ca to connect about options and to confirm.  

This camp is operated by North Hastings Children’s Services, for more information go to www.nhcs.ca or email summercamp@nhcs.ca should you have any questions.  If calling 613-332-0179 please ask for Brianne.

Should you wish for licensed summer care please contact mmccaw@nhcs.ca for more information.
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Primary Family Contact *
Email *
Mailing Address *
Preferred Camp Session? 1st choice 
*Please note - camp is closed on Stat holidays
 *
Preferred Camp Session? 2nd choice *
Summer Camp would greatly benefit from a donation. Please check the box below with your donation amount.  
Options are through internet banking (arranged with Scotia, TD or Kawartha Credit) using you last name as the account number and ESC to assign it as donation. 
 *
Family Information- Only these contacts may pick-up the child(ren) unless otherwise provided in writing to the Camp Supervisor. Identification may be required or requested before release of the child(ren). Please provide last name, first name, relationship to child (parent/guardian/family friend), home phone, cell phone, work phone, email address and full mailing address. *
Are there custody arrangements we need to be aware of? If there are restrictions on either a spouse or an individual visiting the camper, full documents must be provided to North Hastings Children's Services CEO, Jessica Anderson prior to the child(ren) attending camp at janderson@nhcs.ca.  All information will be kept confidential and only restrictions will be shared with camp staff. *
In order to determine eligibility for funding to support participation in Experience Summer Camp, please check off if the following statement applies to you:

My family struggles financially and we cannot afford a camp opportunity and/or my family has had contact with a child welfare agency.

This information will be kept confidential and no names will be disclosed.
 *
Required
Child #1 Information - First and Last Name
Child #1 Information - Date of Birth
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Child #1 Information - Age of camper as of December 31, 2024
Child #1 Information - Doctor's name, phone number and address.
Child #1 Information - Address of residence
Child #1 Information - Allergies and/or any other special medical or additional health information: All medication must be labelled and brought in the bottle from the pharmacy. Severe allergic reactions/ risk of Anaphylaxis will require an *Anaphylaxis Emergency Plan* form be completed and signed by the physician prior to attending camp. If medication is required you will receive a *medication form* to complete prior to the child(ren) attending camp. Please detail all information below.
Child #1 Information - Please detail any additional information we may need to know that would help us to support your child at summer camp?
Child #1 Information - Emergency Contact (First and last name, relationship to child, home, work and cell phone numbers)
Child #2 Information - First and Last Name
Child #2 Information - Date of Birth
MM
/
DD
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YYYY
Child #2 Information - Age of camper as of December 31, 2024
Child #2 Information - Doctor's name, phone number and address.
Child #2 Information - Address of residence
Child #2 Information - Allergies and/or any other special medical or additional health information: All medication must be labelled and brought in the bottle from the pharmacy. Severe allergic reactions/ risk of Anaphylaxis will require an *Anaphylaxis Emergency Plan* form be completed and signed by the physician prior to attending camp. If medication is required you will receive a *medication form* to complete prior to the child(ren) attending camp. Please detail all information below.
Child #2 Information - Emergency Contact (First and last name, relationship to child, home, work and cell phone numbers)
Child #2 Information - Please detail any additional information we may need to know that would help us to support your child at summer camp?
Child #3 Information - First and Last Name
Child #3 Information - Date of Birth
MM
/
DD
/
YYYY
Child #3 Information - Age of camper as of December 31, 2024
Child #3 Information - Doctor's name, phone number and address.
Child #3 Information - Address of residence
Child #3 Information - Allergies and/or any other special medical or additional health information: All medication must be labelled and brought in the bottle from the pharmacy. Severe allergic reactions/ risk of Anaphylaxis will require an *Anaphylaxis Emergency Plan* form be completed and signed by the physician prior to attending camp. If medication is required you will receive a *medication form* to complete prior to the child(ren) attending camp. Please detail all information below.
Child #3 Information - Emergency Contact (First and last name, relationship to child, home, work and cell phone numbers)
Child #3 Information - Please detail any additional information we may need to know that would help us to support your child at summer camp?
Child #4 Information - First and Last Name
Child #4 Information - Date of Birth
MM
/
DD
/
YYYY
Child #4 Information - Age of camper as of December 31, 2024
Child #4 Information - Doctor's name, phone number and address.
Child #4 Information - Address of residence
Child #4 Information - Allergies and/or any other special medical or additional health information: All medication must be labelled and brought in the bottle from the pharmacy. Severe allergic reactions/ risk of Anaphylaxis will require an *Anaphylaxis Emergency Plan* form be completed and signed by the physician prior to attending camp. If medication is required you will receive a *medication form* to complete prior to the child(ren) attending camp. Please detail all information below.
Child #4 Information - Emergency Contact (First and last name, relationship to child, home, work and cell phone numbers)
Child #4 Information - Please detail any additional information we may need to know that would help us to support your child at summer camp?
Should your child(ren) require medical attention we will make every attempt to contact you. If however, we are unable, do you give us permission to seek medical attention as required?
Clear selection
Please be advised that your child may be photographed for this program and used in promotional material/social media. No names are used. Do you give us permission for your child to be photographed? *
What referring agency is involved with your child attending Experience Summer Camp?
Conditions of Registration: I/we agree to allow my/our children to participate in all camp activities and in any supervised trips to places that are not on the camp property (according to schedule provided). I/we hereby apply for registration for the herein named child(ren) for the camping services indicated in this application. In consideration of acceptance of this application by Experience Summer Camp: I/we hereby agrees as follows: (please select each box to provide agreement).  
Conditions of Enrollment: (please select each box to provide agreement).
Additional Information: We believe Experience Summer Camp offers campers an opportunity to learn and practice positive social skills. Adapting to new groups and counsellors is an important life skill; for this reason, as well as for flexibility we require making group adjustments as needed. We have not included special requests for friends to be together. As well, if your child has social, physical or behaviour barriers it is vital for you to let us know so that we can work together to provide a safe and successful summer for your child.
I/we confirm that all information supplied on this form (including family information, and all individual camper information) is complete and correct and that I/we have read, understood and agreed to all the contents of this form. I agree that all parents and guardians of the camper(s) are in agreement with the contents of this form.
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