Family Camp Registration Package 2014
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Transcript of Family Camp Registration Package 2014
Outdoor Family Fun!
Strengthening Family
Connections, Friendships
and Memories.
SASAMAT OUTDOOR
CENTRE
3302 Senkler Road, BC Belcarra, BC V3H 4S3
Program Starts: 6:30pm
Friday May 30th
Program Ends: 3:00pm
Sunday June 1st
Family Camp Weekend May 30th to June 1st, 2014
For more information contact Brigette, Family Camp Worker at
[email protected] or call 604-736-3588
To Register visit the Kits House Office at 3683 West 4th Ave
Monday-Friday 9am-5pm. Cash or Cheque only.
Register early, space is limited!
www.kitshouse.org
REGISTRATION PACKAGE
INFO SHEET: Family Camp Weekend 2014
Cost of Family Camp: Fees
Adults (19 years+) $115.00
Youth (13-18 yrs) $ 95.00
Children (5-12 yrs) $ 85.00
Toddler (1-4 yrs) $ 75.00
Infants (0-12 months) Free
Family Membership Fee $ 20.00
Empty Bed Charge $ 50.00
Transportation (Kits House Van) $ 12.00 / person ($6.00 each way)
* Note: Actual cost for camp is $115 per person (for anyone over 1 year of age)
Things you need to bring:
Sleeping bag or warm blankets & a pillow
Toothbrush, tooth paste and toiletries
Flashlight
Books, board games, etc. (for time fillers & entertainment)
Clothes for 2.5 days (Sweaters, long pants, runners - one pair for walking &
one pair you don’t mind getting wet)
Rain gear (jacket & pants if possible)
Swim suit & towel (optional)
Things you should know:
Prices include: meals, accommodations, & activities
All meals will be provided: Friday light snack, Saturday breakfast, lunch &
dinner and Sunday breakfast & lunch
All participants will be asked to sign-up for a Volunteer Task
There is a $50 charge for empty beds - if you require your own cabin
All belongings should be labeled & put into a sturdy bag
Non-prescription drugs, alcohol & pets are not permitted on site
If you are providing your own transportation to Sasamat Outdoor Centre,
please arrive after 6:30 p.m. on Friday May 30th, 2014
Parking space at Sasamat Outdoor Centre is limited, so please try to carpool
Kits House Van Transportation:
Families that are registered to travel in the Kits House Van need to arrive with their luggage no later than 4p.m. on Friday May 30th, 2014
**Registration for Family Camp Weekend is on a first come first served basis**
DIRECTIONS TO SASAMAT OUTDOOR
RECREATION CENTRE How to get here
From the corner of St. John's Street and Ioco Road in Port Moody, turn North
onto Ioco Road. Turn left at the third traffic light and follow the signs to Belcarra
Regional Park. Turn right onto 1st Ave. which becomes Bedwell Bay Road. Drive
past the turnoff to White Pine Beach. Turn right at the stop sign, towards the
Village of Belcarra. Finally, turn right onto Senkler Road, the first road to your
right after entering the Village of Belcarra, and follow the wooded driveway into
Sasamat Outdoor Centre.
Translink Belcarra/Port Moody - #C26 If you are taking the Translink Shuttle
Link: http://sasamat.org/directions.html
Sasamat Outdoor Centre Camp Site Map
Registration Form
Full Name of Participants: Fee Amount:
Adult: __________________________________________________ ________________
Adult: __________________________________________________ ________________
Child: ______________________________________age: ________ ________________
Child: ______________________________________age: ________ ________________
Child: ______________________________________age: ________ ________________
Child: ______________________________________age: ________ ________________
KNH Van Transportation: (# of participants _____ x $12): ________________
KNH Family Membership ($20): ________________
Contact Information: Total Fees: ________________
Address: _______________________________________ City: ________________________
Postal Code: _________________ Phone #: _____________________________
E-mail: ___________________________________ Cell #: _____________________________
Questions:
1.Accommodation Preference—COTTAGE (4) / CABIN (6) ?
2.Diet Restrictions—please specify any allergies we should be aware of:
_______________________________________________________________________________
3.Car Pooling—are you able to drive another family? Y / N If yes, how many: _____
Registration Form
Waiver / Release Form
Medical Form
Amount Paid:_______
Receipt #:__________
Membership #:______
KNH Van Registration
Subsidy Form
KNH E-Newsletter
For Office Use Only: (check all information that applies)
Waiver / Release Form
I / we agree that members of our family will follow all reasonable instructions and directions of the
leaders and instructors duly appointed by the Association of Neighbourhood Houses (ANH) in
connection with the operation of the Family Camp Weekend on May 30th to June 1st, 2014.
I / we hereby release, and forever discharge ANH and its agents or volunteers, of and from all
manner of action, cause of actions, claims and demands of whatever nature which result from any
accidental injury, loss or expense sustained, arising out of in any way connected with participation
in any program, or attendance at any location operated by ANH.
In the event that my child is injured, ill or in need of medical attention and I am unable to be
contacted, I authorize KNH staff to seek medical attention on my behalf.
I / we authorize or do not authorize [circle one] Kitsilano Neighbourhood House (KNH) to use
and publish testimonials, feedback, photographs and video taken of me / family / child(ren) while
participating at Family Camp, for use in promotional materials, including but not limited to: posters,
website, social media, and advertising. This waiver release includes the right to modify and
retouch the above in the tasteful discretion of Kits House staff. I understand that there will be no
compensation to me for this use.
PRIVACY STATEMENT
Kitsilano Neighbourhood House and the Association of Neighbourhood Houses
respect your family’s privacy. The information collected on this form is in compliance with the BC
Personal Information Protection Act and is used to process program registration, help ensure the
safety and well being of members and to provide you and your family with information on events
and programs at Kitsilano Neighbourhood House. If you have any questions or would like a copy
of the ANH Privacy Policy please contact our office at 604-736-3588.
Kitsilano Neighbourhood House reserves the right to cancel a program
if there is low attendance or registration. A full refund will be issued for any
program cancelled.
___________________________________________
Name of Parent / Guardian (please print)
___________________________________________ _________________
Signature of Parent / Guardian Date
Medical Form **A Medical Form is needed for every family member**
Medical Form **A Medical Form is needed for every family member**
Medical Form **A Medical Form is needed for every family member**
Medical Form **A Medical Form is needed for every family member**