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CAMP WONDER
Counsellor In Training Registration
Thank you for your interest in
CAMP WONDER
! We are excited to have you be part of the Camp Wonder Team! Please fill out the registration form below.
Cheques can be made payable to Opal Family Services.
Questions? Please call 506-457-9520
Please complete registration form below
CIT Info
*
Indicates required field
Please choose your Camp Wonder Location Preference (Please note: previous camps have been at the sourthside location):
*
Christ Church Parish - 245 Westmorland St. (South Side)
Nashwaaksis Baptist Chuch - 104 Edgewood Dr. (North Side)
Either Location Works
CIT's Name
*
First
Last
Date of Birth (DD/MM/YYYY)
*
Grade Completed:
*
Medicare Card Number
*
Gender
*
Female
Male
Other
Please select which week(s) you are applying for
*
Week 1: July 5- 9
Week 2: July 12 - 16
Week 3: July 19 - 23
Week 4: July 26- 30
Week 5: Aug 3 - 6
Week 6: Aug 9- 13
Week 7: Aug 16- 20
Week 8: August 23 - 27
Duration Preference
*
Half Day
Full Day
Family Info
Parent/Guardian #1
*
First
Last
Relationship to CIT
*
Address
*
Line 1
Line 2
City
State
Zip Code
Country
Phone Number #1
*
Phone Number #2
*
Email
*
Parent/Guardian #2
*
First
Last
Relationship to CIT
*
Address
*
Line 1
Line 2
City
State
Zip Code
Country
Phone Number #1
*
Phone Number #2
*
Email
*
Emergency Contact Info
Please provide TWO additional contacts who can be contacted
if we are unable to reach you.
This can be a friend or family member, etc
Emergency Contact #1
*
First
Last
Relationship to CIT
*
Address
*
Line 1
Line 2
City
State
Zip Code
Country
Phone Number #1
*
Phone Number #2
*
Emergency Contact #2
*
First
Last
Relationship to CIT
*
Address
*
Line 1
Line 2
City
State
Zip Code
Country
Phone Number #1
*
Phone Number #2
*
Wellness Information
*All camp staff members have signed confidentiality agreements and will use this information only to ensure safe and individualized support to your child at camp.
Please describe any needs camp staff should be made aware of:
*
Current Medical Information
*
Type 1 Diabetes
Type 2 Diabetes
Bleeding/Clotting
Cerebral Palsy
Heart diseases/Defect
Epilepsy
None
Are there any other Health/Wellness needs we should be made aware of?
*
If you checked box(s) above, please provide more information about your CIT below. (Ie. Epilepsy: Specific causes)
*
Please list all medications your child is currently taking. Include Name, Condition it treats, dosage, administration time, and any further instructions you feel necessary
*
Allergies
Please note:
Snacks are provided but campers are expected to bring their own lunch.
* No nuts will be permitted at camp
Please describe all allergies your child has. Including allergin name, type of reaction, and treatment (epipen/benadryl)
*
* If Epi-Pen treatment has been indicated above, please ensure that your child brings it with them to camp and that staff are aware of its location.
Please check all applicable areas
*
Asthma
Wheezing with breathing
Wheezing with Exercise
Wheezing from environmental allergins
If yes to ASTHMA please indicate triggers
*
* If your child has been prescribed a puffer, please ensure that he/she brings it with them to camp and that staff are aware of its location.
Dietary Info
Does your child have any dietary restrictions?
*
Halal
Lactose-Intolerant
Vegetarian
Gluten-Intolerant
Celiac
None
Other Dietary restrictions not listed above?
*
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About Camp
Register Now
Contact Us
Register Now CIT