*ALERT* Heartland Forest is proud to offer an inclusive camp.   If your child has any level of special need (identified or suspected: behavioral; communication; developmental; intellectual; physical; emotional; social) – you must contact Amy Brunning or Lisa Staton to arrange for an interview.  CLICK HERE FOR MORE INFORMATION

We reserve the right to remove your child from camp if any special needs have not been declared prior to attending camp. This ensures the safety and well-being of all camp participants and enables your child to have the best camp experience.  Please note: food and insect allergies do not qualify as special needs.

Fields marked with an * are required

Payment is due at time of registration in order to confirm your place.

Credit card payments can be made over the phone (MC or VISA). Cash or cheques are accepted at the Nature Centre, Mon-Fri 9:00-4:00.

Refund-and-Payment-Policy - Click Here


Program Participant Profile


Emergency Contact Information



Emergency Contact (other than parent/guardian)


Permissions Granted

Name & phone of those allowed to pick up/sign your child out of camp (if unfamiliar to our staff, they may be asked to show picture I.D.):


Health Card/Allergy Information

If yes, you will need to complete the Medication Administration Request Form.


Consent

I hereby give the staff and volunteers of Heartland Forest full permission to use the information provided in this form for helpful program and service delivery. The information I have provided on this form is true and accurate to the best of my knowledge.


Participation Waiver

Image Release
My child has permission to participate in media coverage and photographs at Heartland Forest Nature Experience. I hereby grant Heartland Forest the right and permission to publish photos for the purpose of, without limitation, television, publication, and trade or advertising purposes. Accordingly, I release and discharge Heartland Forest staff & respective board members from any liability by virtue of blurring, distortion, alteration, optical illusion or use of composite from that may occur or be produced in taking of said media or any processing through completion of the finished product.

Emergency Medical Consent
By enrolling my child in any Heartland Forest day camp or other program/activity, I hereby authorize the procurement of whatever emergency medical treatment may be necessary for my child. I also authorize the removal of my child from camp premises for the purpose of obtaining such emergency medical treatment if the need so arises. I agree to hold Heartland Forest Nature Experience harmless for the nature, performance, and outcome of any such emergency medical treatment and that the determination of whether an emergency has arisen shall be left to the sole discretion of Heartland Forest Nature Experience.

Acknowledgement & Assumption of Risk
The participant and parent or guardian acknowledge that they are aware of the details of camp and that there exists an element of personal risk or damage of serious injury in the activities and willingly agrees to assume responsibility for those risks as a condition of registering for the program.

Indemnification & Release
I hereby represent that my child has no physical restriction which would prohibit his/her participation in the activities of camp. On behalf of my child I save and hold harmless Heartland Forest Nature Experience or any of their agents, representatives, employees or assigns for my child’s health, safety, or any injury and/or disability arising out of or resulting from program activities.

I acknowledge and have read, understood and agree to the above Waiver, Release and Indemnity. I hereby understand that my child will follow the rules and regulations as set out by the organizers of the camp, and that by not adhering to the rules and regulations, he/she may not only endanger himself/herself, but permission may or will be revoked and he/she will be asked to leave the premises.

 

I have read and agree to this waiver and indemnity.