Fall Forest School Fall 2022 Norfolk Forest School Registration Form Fall 2022 Norfolk Forest School Registration Form Select days for your child to attend 3 year olds: Monday Tuesday Wednesday (FULL) Thursday Friday (FULL) 4-6 year olds: Monday (FULL – waiting list only) Wednesday (FULL – waiting list only) 7-10 year olds: Thursday Participant Name * Name First First Last Last Age * Date of birth * Sex * Male Female Mailing address * Mailing address Mailing address Mailing address Town Town Province Province Postal Code Postal Code Parent / Guardian 1 Name Name First First Last Last Place of employment Email address Home phone Work phone Mobile phone Parent/ Guardian 2 Name Name First First Last Last Place of employment Email address Home phone Work phone Mobile phone Alternate emergency contact (if a parent cannot be reached) Name Name First First Last Last Relationship to participant Home phone Mobile phone Participant release permissions Person(s) to whom the participant MAY be released: Person(s) to whom the participant MAY NOT be released: Medical Doctor's name Child's health card number Does your child have allergies? Yes No If yes, please explain Emergency Procedures or Specific Instructions for above Does your child have any health problem or limitations that would affect their participation in programs? (hearing, speech, physical or emotional delays) Is your child on any medications? Yes No If yes, provide details My child will be responsible for her/his own medication I agree Other information about your child you wish to provide Payment The program cost is $55/day/child. The program runs from 9am – 4pm. A deposit of $275 is required with registration. Subsequent payments are due on the first day of every month Forest School is held. NCEE allows up to 3 sick days per Term where payment is waived as long as parents contact us and let us know of the child’s illness. If a parent withdraws their child after the first 2 weeks of the Term, payments for that Term are still required until a replacement for that spot is found. Payment options * Interac e-transfer Cheque E-mail address to send e-transfers to: info@naturescalling.ca Cheques should be mailed to: Nature’s Calling Environmental Education P.O. Box 995 Simcoe, ON N3Y 5B3 Cancellation and Refund Policy If a day’s program must be cancelled due to educator illness or inclement weather, a full refund for the day will be issued. Nature’s Calling will make every effort to notify parents (by email, telephone, text) as soon as possible so alternate arrangements for their child can be made. Assumption of Risk and Consent I, the undersigned Parent / Guardian of Child's name * do hereby consent to her/his participation in the Eco-Explorer Summer Day Camp. I understand that the camp occurs in a mainly outdoor environment. I understand all program daily commencement and completion times. I also understand that I must be timely in my drop off and pick-up of my child. I am aware that there are potential risks and hazards associated with my child’s participation in NCEE programs. I understand that the hazards include, but are not limited to: Outdoor Environment: Navigation in unfamiliar territory; slips, trips or falls; trees and other natural objects. Allergic Reactions: allergic reactions resulting from contact with cultivated or wild plants; food or drinks; spider, tick or insect bites. Physical Activities: bumps, collisions, falling, tripping, bruises, broken bones, sprains, eye injuries; failure to play safely within one’s own ability. Weather: changing weather conditions; wet weather; snowy weather; the effects of heat or strong sunlight. Other Hazards: the possibility that my child, or others do not heed safety instructions or restrictions given to them. I acknowledge that accidents may occur during my child’s participation in NCEE programs and can occur without fault on either the part of my child or NCEE staff. I am aware that NCEE will take all necessary safety precautions and will attempt to minimize any risks associated with program activities. Accidents however, may cause loss of personal property, injury or even death. I understand that my child is expected to be respectful and considerate to other participants and NCEE staff, and must adhere to the rules with regard to student behaviour as set out above. I further understand that inappropriate behaviour on the part of my child may result in her/his removal from Norfolk Forest School and that I will not receive any refund of fees. To ensure the safety of all summer camp program participants: physical violence, harassment, bullying or foul language will not be tolerated. Parents/guardians will be notified if their child’s behaviour is inappropriate. If such inappropriate behaviour continues, NCEE reserves the right to remove the child from the Program and to refuse any further participation. No money will be refunded. I understand that my child will be solely responsible for her/his personal property and effects during Norfolk Forest School and acknowledge that it is recommended that valuable items are not brought on to the property. I release Nature’s Calling Environmental Education and their staff / volunteers from any claim arising from such risks. If at any time emergency medical treatment is necessary for my child, I give consent for treatment to be given. Every effort will be made to contact parent/ guardian(s) and/or emergency contacts. Note: In the event of a serious illness or injury, your child will be sent to Simcoe General Hospital. I/We, agree with, and support the rules and guidelines set out in Nature’s Calling Environmental Education’s Policies and Procedures Parent Handbook and their Covid-19 Guidelines document. I/We understand and support the decision to not wear masks and that NCEE educators will not strictly enforce physical distancing. I consent to my child’s photo being taken using photograph or video. I further understand and authorize that pictures taken at camp may be used for promotion (i.e. social media, print media, NCEE publications and website, and other forms for advertising and promotion). I hereby waive any right to inspect or approve the finished product or advertising or other copies that may be used in connection therewith or the use to which they may be applied. I understand that this material remains the property of Nature’s Calling Environmental Education. I agree with and will follow * Release of Liability Assumptions of Risk Medical emergency policy Covid policy Photograph policy Please type your full name * If you are human, leave this field blank. Submit