Wired 2022 Application
Where? Ryerson Camp, Vittoria, Ontario (students' families are responsible for transportation)
When? Monday, August 22 - Friday, August 26, 2022
Price: $200.00 in June, 
           $225 in July, and 
           $250 in August (includes lodging, food, program)
Packing List to be sent to participants in a registration package
Sign in to Google to save your progress. Learn more
Email *
Camper Information
Student's Last Name *
Student's First Name *
Gender *
Date of Birth *
MM
/
DD
/
YYYY
Student's Grade in Fall 2022 *
Contact Information
Parent/Guardian Name *
Parent/Guardian Phone Number *
Parent/Guardian Email Address *
Mailing Address *
Emergency Contact (if Parent/Guardian cannot be reached) Name *
Emergency Contact Relationship to Camper *
Emergency Contact Phone Number *
Medical Information
Camper Health Card Number *
What allergies or medications does this camper have?
What conditions or concerns may hinder this camper from participating fully in camp activities?
Camper T-shirt Size *
What additional information should the Wired 2022 team know about this camper?
Conditions of Enrolment
1. This camper has my permission as his/her Parent/Guardian to attend Wired and participate in all activities on the property of Ryerson Camp.
2. The parent/guardian submitting this application has legal custody over the camper.
3. The Camp Directors reserve the right to dismiss any camper who in his/her opinion is a hazard to the safety of others or who appears to have rejected the reasonable expectations of the camp. Responsibility to transport the camper home is mine as his/her parent/guardian.
4. The parent/guardian hereby agrees to reimburse the camp for any property damage caused by the camper.
5. While every precaution shall be taken to ensure good welfare and protection of the camper, Wired, West London Alliance Church, its staff and board members, employees and volunteers or facilities outside the church property are hereby released from any and all liability in the event of any accident, illness, or misfortune that may occur to the camper.
6. I hereby authorize Wired personnel to handle any medical problem with my camper during his/her stay at camp. After making every reasonable effort to contact the parent/guardian and emergency contact listed in this application, permission is hereby given to the physician selected by camp directors to provide proper treatment. This may include being removed from the site to a local hospital. The parent/guardian is responsible for any additional expense that might arise from such a service.
7. Permission is also granted to the camp nurse to administer any over the counter medication according to the package instructions, or any prescribed medication according to the label.
8. There will be no reduction of fees for campers arriving late, leaving early, or expelled through disciplinary action.
9. West London Alliance Church has permission for the reasonable use of camp pictures containing this camper's image in future promotional materials (brochures, videos, displays, websites).
10. All information collected in this registration will be used only by Wired for the specific purpose of providing an excellent summer experience for your camper.
I have read the WIRED 2022 Application Form, have provided true and accurate information, and am in full agreement with the conditions of enrolment. *
Required
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
PrivacyTerms
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy
Google Forms