UNF Children’s March Break Camp

Please complete ALL sections of this form as applicable. By completing this form you are acknowledging that you are waiving certain legal rights and hereby warrant and represent to UNF Children’s March Break Camp as well as the Ukrainian National Federation of Canada (including and any and all of its branches), and any of their respective affiliates, directors, officers, volunteers, staff and employees, contractors, representatives, licensees, agents, or successors (collectively, the “Organization”) that: (1) you are over the age of majority in your jurisdiction of residence; and (2) you are registering on behalf of minor and are the minor’s parent or legal guardian and are fully authorized and permitted to enter into this agreement on behalf of the minor Participant.

01. Camper's Details (As Given on Health Card)

Click or drag a file to this area to upload.
Photo of Camper must be in .jpg or .pdf format.

02. Camper's Physical Description

03. Camper's Home Address

04. Parent(s) or Guardian(s) Information With Whom Camper Resides:

05. Additional Parent(s) or Guardian(s) Information

06. Emergency Contact Details

A minimum of two Emergency Contacts over the age of 16 are required and must be different from the parents and guardians listed above. I authorize Camp Soniashnyk to contact the individuals below in the event that I am not immediately available.

07. Camper's Physician Details

08. Pre-Existing Medical Conditions and Allergies

If there are any special needs, medical conditions, allergies, dietary restrictions, behavioural or physical concerns, that would interfere with the camper's camp life and activities please complete Appendix A at the end of this application.

09. Camper’s General Experience

10. Camp Session Registration

11. Parent Signature and Acknowledgement

I give permissions for the Camper to leave the Camp premises to participate in field trips and I give permission to the staff of Camp Soniashnyk to take the Camper to all scheduled trip locations during the session in which the Camper is registered. I agree that the Camper may be transported by to trip sites by school bus, public transportation or walking. I understand that the Camper will be escorted and supervised by Camp staff during this trip.
I hereby consent to any first aid treatment or medical emergency treatment being given or provided to the Camper as may be necessary or warranted under the circumstances and hereby give permission that in the case of an emergency and I cannot be immediately reached, Camp staff may hospitalize and authorize treatment for the Camper, including but not limited to the provision of anesthetics, injections and/or surgery. I also give permission for Camp staff to transport the Camper to the emergency department at the nearest hospital, without any liability on the part of the staff member. Furthermore, I agree to accept financial responsibility for any costs associated with the Camper receiving medical treatment. I also agree that the information in this Form and any attachments hereto can be disclosed to emergency and health personnel. I confirm that I have provided complete and accurate medical information for the Camper and permit the Camper to participate in the full range of Camp activities, except as I have explicitly noted on the Medical Information Form attached hereto as Appendix “A” on page 5. I hereby agree and undertake that I will use best efforts to make myself available and be reachable at either of the phone numbers I have listed in this Form at all times.
I give permission for the Camper to participate in all Camp activities and I understand that some of the activities, such as but not limited to, canoeing, swimming and water sports, may be inherently dangerous and/or involve risks. In consideration of the Camper’s opportunity to participate in the Camp, the receipt and sufficient of which is hereby acknowledged, I hereby release and forever discharge the Organization in respect of any and all claims, actions, losses, damages, costs, and expenses, including but not limited to loss of income, in relation to any and all personal injury to or death of the Camper or any other person, or any loss of or damage to property, arising in any way at, from or in connection with the Camp programs and services and any and all matters set out in this Registration Form, howsoever caused, and I agree to indemnify and save harmless the Organization with respect to same. I am providing this release and indemnity on behalf of the Camper, as well as in my personal capacity on my own behalf, and on behalf of my spouse and any other persons who may be entitled to assert such a claim, and agree that this waiver and indemnity shall be binding on my personal representatives, heirs and successors. I understand that although every effort is made to send Campers home with all of their belongings, the Camp is not responsible for any loss or damage. I have read this Form and any attachments hereto fully, and understand its terms and that I am giving up substantial rights by signing it. I have signed this form freely, voluntarily and without any inducements or assurance of any nature and intend it to be a complete and unconditional release of all liability to the greatest extent allowed by law and agree that if any portion of this Form and any attachments hereto are held to be invalid, the remaining terms and provisions shall continue to be in full force and effect. I confirm having been advised that I should obtain independent legal advice prior to signing the Registration Form and any attachments thereto.
I hereby authorize any images or recordings taken of the Camper and/or me, as applicable, and any work, art or performance of the Camper (“Work”), in relation to the Camper’s participation in Camp Soniashnyk, to be used by the Organization for promotional, informational, publicity, and marketing purposes, and authorize the publication and/or display of said materials publicly, whether on a website, social media, television, in print or otherwise. I also consent to the release of the Camper’s name but only as it relates to the Camper’s participation in the Camp. I hereby relinquish all rights, title, interest and royalties I and/or the Camper may have in any of the said images, recordings, and Work, and hereby release the Organization from any and all claims or demands for damages of any kind whatsoever arising from the Organization’s use of said materials. I understand that said materials may be used and may be reproduced by third parties and I agree that I will not hold the Organization responsible from any harm or damages that may arise as a result.
I confirm that I have read and understand the Camp Soniashnyk Policies outlined in the Policy Book which were sent to me via email at time of confirmation of registrion and I agree to abide by and be bound by the policies. I further confirm having reviewed the policies with the Camper. Camp Soniashnyk reserves the right to cancel the Camper’s participation in the Camp and any of its programming if the Camper’s behaviour is deemed unmanageable, inappropriate or dangerous in the Camp’s sole discretion, in which case any registration fees paid will be non-refundable, and I hereby acknowledge and agree that I will be responsible for any and all costs associated with such dismissal. I also have read and understand the refund policy where no refunds or credits may be applied after registration is confirmed, whether or not the camper has attended camp.
I hereby agree that the information in this Form and any attachments hereto can be disclosed to the Organization as applicable in relation to the Camper’s participation in the Camp and/or the administration of the Camp’s programming.
I agree to be contacted in regards to UNF Camp News and Events during, but not restricted to, the duration of camp. I acknowledge that I may remove my name from the contact lists at anytime after camp dates by contacting [email protected]. I understand once my name is removed I will not be contacted for early registration

12. Signature of Both Legal Guardians

By signing this Form, I confirm and acknowledge that I have carefully read and fully understand the terms in this Form and any attachments hereto, and that I irrevocably agree to the Terms set out therein.

APPENDIX "A" - Medical and Safety Information Form

I hereby confirm that the information in this Medical Information Form is complete and accurate. I understand I must pick up my child within a reasonable amount of time if the Camp Director deems them too ill to participate in camp activities. I authorize Camp staff to administer any medication/puffers/injections that have been brought with the Camper to Camp and by signing this Form, and I understand that no medications/puffers/injections are to be kept in the office or on the Camper’s person unless otherwise indicated by a doctor in writing. By signing this Form and in consideration of the Camper’s opportunity to participate in the Camp, I hereby release and forever discharge the Organization in respect of any and all claims, actions, losses, damages, costs and expenses in relation to Camp staff administering any medications/puffers/injections as set out herein, howsoever caused, and agree to indemnify and save harmless the Organization with respect to same.