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Important Registration Information

• REMEMBER TO REGISTER EARLY AS SPOTS ARE LIMITED!
• Complete one form per camper.
• Credit card payment can be made in full or a $50 non-refundable deposit per camper per session.
PAYMENT IS DUE IN FULL BY JUNE 1st.
• If registering after June 1st full payment is due.
• If cancellations are made three or more weeks prior to session, the fee less the deposit ($50 + GST) will be refunded. If less than three weeks prior to session, no refund will be issued (unless a doctor’s certificate is provided in case of medical emergency). No refund will be issued for dismissal due to disciplinary action, late arrival or early arrival. Deposits and fees are non-transferable.
• Camper Scholarships may be available based on financial need. Please contact our office for details.


Camper Information

First Name Initial Last Name Gender
Male Female
Address Town/City Province Postal Code
Birthday (MM//DD/YYYY) Age by Dec. 31 of camp year Grade
/ /  
Personal MB Health # Family MB Health #    
     
Cabin Mate Request (Both campers must request each other and be of the same age and same gender- max 2 names.)
     

Bring A Friend - Sign up a friend to come to camp on the same week as you and receive a $15 store credit as a Thank You! (Friend cannot have been to Camp Arnes before and cannot be a sibling, and two first time campers cannot sign up each other.)
Name of Friend    

Parent / Guadian Information
Parent / Guardian Name:
Father's First Name:
Father's Last Name:
Mother's First Name:
Mother's Last Name:
Mother Home Phone:
(including area code)
eg. 204-555-5555
Mother Work Phone:
(including area code)
Mother Cell Phone:
(including area code)
Father Home Phone (if differs):
(including area code)
Father Work Phone:
(including area code)
Father Cell Phone:
(including area code)
E-Mail:
If parents are divorced or legally separated, who has custody?  Mother  Father
If parent(s) /guardian cannot be reached in an emergency, please contact: Relationship of emergency contact person to camper:
Home Phone Work Phone Cell Phone
Church Denominational / Religious Background (optional)

Carpool Information (photo ID will be required)
In addition to the parents/guardians, only people on this list will be allowed to pick up your child.


Health Information

List any Allergies your child has including food and/or medication. Reaction to the allergen and how it is handled
Please list any MEDICATION your child is on, as well as the DOSAGE AND TIMES it is administered.
Any of the following needs that may require special attention at camp?

PHYSICAL  EMOTIONAL  BEHAVIOURAL

If any of the above is checked, please specify:


Does your child have any of the following. (check all that apply):

Asthma
Seizure Disorder 

Migraines 
Bed Wetting 

Please give any other helpful information for your child:

Camp Arnes receives standing orders from a licensed physician.  Should your child have a headache or become ill it may be necessary to give them medications that are administered by the camp nurse.
Please list any medication you DO NOT want your child getting from the nurse while at camp:

Medical Policy:

All prescribed medication must be sent in the ORIGINAL BOTTLE (pleas send sufficient supply with a few extra).  All medications will be administered by the camp nurse.  If the medication is not in the original bottle or the label is not legible IT WILL NOT BE ADMINISTERED.  Any over-the-counter medication must be in the ORIGINAL PACKAGE and be accompanied by parent instructions.

Clean and Green

By raising money for Camp Arnes you can reduce your fees for the summer. More information is available here.
Sign me up for Clean and Green to help lower my cost of camp.
I agree to take full responsibility for my receipt book, all money I collect and I promise to return the receipt book(s) and money in full otherwise I agree to pay a fee of $100 to Camp Arnes.

Program Dates & Fees Please choose one camp session per registration from. If you would like to sign up for multiple weeks please call our Registrar at 204-338-4647 after you have submitted this form. *Integration Camping Available.

*Teddy Bear Camp (ages 6-7)  
$187.95 w/GST ($179 no GST)
July 1 - July 3, 2010
Paintball (ages 12-15)  
$460.95 w/GST ($439 no GST)
July 5 - July 10, 2010 (Ages 12-13)
July 12 - July 17, 2010 (Ages 14-15)
July 19 - July 24, 2010 (Ages 12-13)
July 26 - July 31, 2010 (Ages 14-15)
August 2 - August 7, 2010 (Ages 12-13)
August 9 - August 14, 2010 (Ages 14-15)
August 16 - August 21, 2010 (Ages 12-13)
Adventure Canoe Trips  
$460.95 w/GST ($439 no GST)
July 17 - July 24, 2010 - Beginner (ages 12-14)
July 31 - August 7, 2010 - Intermediate (ages 13-15)
August 14 - August 21, 2010 - Intermediate (ages 13-15)
Leadership Training (ages 16-17)  
Please check online for an application.
*New Drama Camp  
$460.95 w/GST ($439 no GST)
Limit 8 campers/week
August 2 - August 7, 2010 (Ages 12-13)
August 9 - August 14, 2010 (Ages 12-13)
August 16 - August 21, 2010 (Ages 14-15)
Click here for Ignite / LTP Leadership Training Program Application Form

Additional Information    
Early Bird Discount Deduct $26.25 w/GST per registration. Your application with $50 deposit must be received at Camp Arnes on or before Feb. 19, 2010. Full balance must be received by March 31, 2010 or early discount will be removed and the FULL FEE will be applied.
Early Bird
Sibling Discount For each child that has a sibling attending Camp Arnes, deduct $26.25 w/GST ($25 no GST) per child per session. To qualify for the sibling discount, all registrations must be sent at the same time. This discount does not apply to children registering through agencies.
Please type the names of siblings

Volunteers Parent volunteers who come receive a discount of half a regular camper fee $190.05 w/GST ($181 no GST) for working one camp session. Volunteers can work in maintenance, kitchen, dining room or corrals. An application form will be sent to you.
I would like to apply to Volunteer
Nurse Volunteers Nurse volunteers receive a discount of one full camper fee. Nursing credentials required. An application form will be sent to you.
I am interested in being a Nurse Volunteer
Transportation Needed Campers need to be at 173 Talbot Monday morning at 8:00 for 8:30 departure. Bus returns to 173 Talbot at 2:30pm on the last day of camp.
Bus to Camp (Free)

Yes No
Bus to City ($10)

Yes No
Pre-Paid Tuck No need to send money with your camper on their day of arrival at camp! Include the amount of spending money you wish your child to have at camp on this registration form and it will be added to their account. Campers can spend up to $4.00 a day on refreshments and will also be able to buy souvenirs.
Pre-Paid Tuck Amount:
How did you hear about Camp Arnes?   Church
Mall Display
Friend
Website Listing
Billboards		 Arnes Mailing
Community Centre
Medical Clinic
Radio Ad
Other
Pre-Order your Survival Pack for $36.00
(no GST) includes a hat, water bottle and t-shirt. 		Yes No
Pre-Order your Pre-order T-Shirt for $15.00
$15 (no GST) pre-ordered or $17.00 at camp 		Yes No

Payment Method You must enter credit card information for this form to be submitted.

Method of Payment
Card # (no space between #s)
Expiry Date /
Name on Card

Payment Options

Deposit now, rest of payment charged on either March 31 (Early Bird) or June 2 (Regular registration)
Payment in full

Conditions of Enrollment

1. The Director's reserve the right to dismiss a camper who in his opinion is a hazard to the safety of others, or who
appears to have rejected the reasonable controls of the camp. If this occurs, the fee is non-refundable.

2. I give permission to Camp Arnes to use photographs/videos of the camper for promotional material.

3. The parents/guardians submitting this form are those having legal custody of the child. Conditions of custody, if
applicable, must be fully communicated in writing to the camp.

4. The parents/guardians, recognizing that Camp Arnes will do its part to provide qualified, well trained staff and a safe
environment; agree to assume all risks, and to release, indemnify, and save harmless Lake Winnipeg Mission Camp
Society Inc., its affiliated organizations, and its employees and representatives (on whose behalf this agreement is
made) from injury, loss or damage that may occur to the camper or camper's property.

5. The camper is covered by Provincial Health or equivalent medical insurance.

6. All prescribed medication must be in the Original Prescription Bottle (please send sufficient supply with a few extra). All medications will be administered by the camp nurse. If the medication is not in the original bottle or the label is not legible It Will Not Be Administered. Please do not send non-prescription medication unless camper is on them on a regular basis (ie. Tylenol). Infirmary has a supply at camp for most situations and maintains general standing orders with a qualified physician.

7. I herewith give consent for the camp administration to secure medial treatment in the event of an emergency. I give permission for the medical staff to administer medication. I give permission for qualified staff to administer and Epi pen if needed. I will notify the camp in writing if any change occurs in the camper's health within 6 weeks prior to attending camp.

8. I have read this registration form and the program guide and I agree to be responsible for the payment of all fees due to the camp.

9. I certify that the information given above is complete and accurate to the best of my knowledge. Note: this application cannot be processed unless the form is complete, dated, signed and a $50 deposit per camp session is included.

I certify that the information give is complete and accurate to the best of my knowledge.

For more inquiries our registrar.

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