Kindergarten Camp Registration Form 2023
FOR CAMPERS BORN 2018-2019 
Camp fee includes am snack, hot lunch and pm snack( Packed lunch on trip days)
Hours of operation 7:15-6:00
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Email *
Payment and deposit:

An initial non-refundable deposit of 105$ per child ( $100 will be applied to your camp fee + $5 processing fee)

You will receive an invoice for the initial deposit, 3-5 days after receiving an email confirmation from LCCC@rogers.com, which can be paid via QuickBooks directly from your banking institution or credit card.

This option is only available for camp deposits. 

You will then be billed for all registered camp weeks on May 15th, 2023 via EFT( pre-authorized debit) or cheque. We do not accept cash or credit for camp fee payments. 


Camp Cancellations/Refunds:

All camp cancellation requests must be made in writing to Lakeshore Community Childcare Centre by email to lccc@rogers.com 

Camp cancellation requests must be made in writing BEFORE May 1st, 2023

Camp cancellation requests AFTER May 1st until June 19th, 2023 are subject to a full refund less the initial deposit. 

Camp cancellation requests received AFTER June 19th will be reviewed by management on a case-by-case basis. IF APPROVED, you will receive a full refund minus the initial deposit of $105 plus an administration charge of 25$ per week, per camper being cancelled.

Please note: It may take up to 2-4 weeks to receive your refund, which will be deposited in the same account as withdrawn. If paid by cheque we will provide you a PAD form for the refund to be deposited into your account. 


Waitlist:
If the week you chose is sold out you'll be asked if you would like to be put on the waitlist for that week. The waitlist will be on a first-come, first-serve basis. If a spot becomes available we will notify you.
Child's Name: Last, First *
Child's Address: Number, Street, City, Province, Postal Code *
Date of Birth (mm/dd/yyyy) *
MM
/
DD
/
YYYY
Parent/ Guardian Name: **Person filling out the form** *
Parent/ Guardian Cell Phone number: *
Parent/ Guardian Work Phone number: *
Parent/ Guardian Name:
Parent/ Guardian Cell phone number:
Parent/ Guardian email address:
Emergency Contact/s Name and relationship to child: *
Emergency Contact/s Cell Phone Number: *
Emergency Contact/s Work Phone Number: *
Health Card Number
Child's Doctor's Name: *
Child's Doctor's Phone Number: *
Does your child have any allergies, special dietary restrictions or medical requirements? *
If you answered 'Yes':  
1) What is the allergy/ dietary restriction or medical requirement?   
2)What medical attention, if any, is required? 
(**Note: Anaphylactic allergies or asthma requires separate documentation to be completed**)
Authorization to release children (persons other than parents and emergency contacts who are allowed to pick up my child from the centre)  
Name/s of authorized release:
Cell phone number/s of authorized release:
Do you have subsidy? *
If you answered 'Yes', please record your subsidy number below.
K Summer Camp (Children born 2018-2019)          
Please select the weeks that your child will be attending our Summer Camp:
*Trips may be subject to change* 
 *
Required
LCCC T-shirt: 
EVERY child must have an LCCC t-shirt for trips 
$10.00 new /$5.00 used
This will be paid separately. 
 *
What is your child's t-shirt size? 
FIELD TRIP/ LOCAL EXCURSIONS/ACTIVITY: I consent for my child to participate in all field trips  (by chartered bus or public transportation if applicable), local excursions & activities *
PHOTOGRAPH CONSENT:  I consent for photographs to be taken of  my child during these experiences (photos to be used in the centre). *
CONSENT FOR EMERGENCY MEDICAL TREATMENT: Medical  treatment  may be given to my child at any time required due to accident, illness of other emergency. I hereby give my permission that if I am not immediately available, emergency ambulance transportation will be arranged by childcare staff.  The attending physician will administer emergency treatment as required.                                                                   *
ADMINISTRATION OF OVER-THE-COUNTER PRODUCTS: Please indicate below which products may be used on  your child.  Parents are responsible for providing own products, if applicable. With the exception of hand sanitizer and hand wipes which will be provided by the centre.   *
Required
At LCCC we believe every child belongs, to ensure that your child's needs are met. Please indicate below if your child requires extra support whether diagnosed or undiagnosed so we can meet your child's individual needs within the parameters of care. *
By registering, I consent to my above responses: Field Trip/Excursion/Activity, Photographs, Emergency Medical Treatment, Administration of over-the counter-products ***Please type initial or full name below to  accept as an e-signature alternative*** *
Comments/Questions
A copy of your responses will be emailed to the address you provided.
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