Play Your Way Grant - PISE Summer Camp Registration Information
Please fill out the below questions to the best of your ability.  If the question doesn't apply to you please answer "N/A".

If you're filling the form out on behalf of a child or family (social worker, teacher, principal, etc.) please still try and answer the questions the best you can.

Please note: Applications should be submitted 21 days (3 weeks) BEFORE the first day of camp.
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Email *
What is the name of the applicant? (Must be the same as the application form). *
What is your shirt size? *
Pick up List (in addition to those listed previously; ID will be required): Please include NAME, PHONE NUMBER and RELATIONSHIP to participant. *
Pick up List (in addition to those listed previously; ID will be required): Please include NAME, PHONE NUMBER and RELATIONSHIP to participant. *
Contact in Case of Emergency: Please include NAME, PHONE NUMBER and RELATIONSHIP to participant. *
Does your child have any sensitivity to external stimulation? *
If yes, what specific methods of instruction help your child focus or learn? N/A if this question does not apply. *
Persons not permitted to access this child? NAME is only required. N/A if this question does not apply. *
If your child has allergies, does your child carry an Epinephrine injector? *
Are there any medical conditions, allergies or cognitive or physical disabilities that may affect your child? Please include information regarding the signs, symptoms and severity of allergic reaction. *
Please list any medications your child is currently taking as well as timing and dosage requirements. **Note: PISE staff are not permitted to administer medications*** *
Any additional information which could assist PISE with the care of your child: *
Does your child have a favourite sport or activity that they would like played in camp? *
Required
Do you consent to your child having their photo taken (and potentially used in promotional material)? *Note - this is in addition to the photo release form that is sent home in the welcome package. *
Does your child have support staff (educational Assistant - EA, etc.) in school or other programs/camps? *
How did you hear about or find this program? *
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