Camp Registration
Please complete a new registration for each camper you wish to register
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Email *
Camp Week Requested *
If selecting Single Camp Days please specify dates here.
Campers First and Last Name *
Campers Date of Birth *
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DD
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Who has custody of the camper *
Parent 1, Parent 2, Both, Other, etc ...
If custody other, please describe
Parent/Guardian #1 First and Last Name *
Parent/Guardian #1 Primary Phone Number *
Parent/Guardian #1 Primary Email *
Parent/Guardian #2 First and Last Name *
Parent/Guardian #2 Primary Phone Number *
Parent/Guardian #2 Primary Email *
Emergency Contact #1 *
Name and primary phone number, other than parent or guardian listed above
Emergency Contact #2 *
Name and primary phone number, other than parent or guardian listed above
Please describe any dietary, allergy or medical concerns
I have read and agree to the cancelation and withdrawal policies *
All cancellation requests must be submitted by email directly to Giggling Heartz at gigglingheartz@gmail.com with subject line “Withdrawal Request” followed by your camper’s first and last name.Cancellation requests received prior to 5 business days before start of the affected camp session will receive a refund less a non-refundable administration fee of $40. Any refund requests received less than 5 business days prior to the affected camp session or during a camp session will not qualify for a refund. A doctor’s note is required for cancellations due to medical reasons. Refunds may take 2 to 3 weeks to process.
I have read and agree to the camp behaviour policy *
Campers are expected to model  core values of respect, responsibility, caring and honesty. Campers who can not meet these expectations, or become aggressive or violent will be removed from the camp program. No refunds will be given for campers removed for behavioural reasons.
I have read and agree to the authorization policy *
In permitting my child to attend day camp programming offered by Giggling Heartz, I authorize that in the event of an accident or illness affecting the child indicated through this application, authorize all procedures, including admission to the hospital and necessary treatment herein, as deemed essential for the care and well being of said child. Such action is to be taken only when immediate contact with the emergency contacts or other indicated authorized contacts cannot be made. All costs of handling an emergency situation is the direct responsibility of the parent/guardian and we waive Giggling Heartz of all liability and monetary costs.
I have read and agree to the policies and procedures as outline in the Parent Handbook
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I authorize my child to participate in all programs. *
Does your child require Extended Care *
Extended care is available for an additional monetary fee.. Supervision begins at 7:00am before the camp day and closes at 5:00pm for an additional fee of $30 per week or $6.00 per day.
Photo consent *
I understand that photographs, images or recordings containing my child’s picture my be used for promotion on the Giggling Heartz website; and the social media, outlet Facebook  By checking “Yes”, I am granting my permission.
Payment *
Payment is required in the amount of $175.00 per week of camp or $45 per day for single day camp and is due upon receipt of your confirmation email.. Extended Care is an additional $30.00 per week of camp.  PA Days are charged at a rate of $45.00 per day and PA Day and Single Day Camp  Extended Care is an additional $6.O0. per day. Please state  your preferred payment method below.
Registration Confirmation *
I understand that registration is not complete and secure until I have received a confirmation email from Giggling Heartz and all camp fees are paid in full.
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