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Organization:

Minnekhada Middle School

Event:

Minnekahda Summer Camps

Date/Time: Tue, 02-Jul-2024 10:00
Location: 1390 Laurier Ave, Port Coquitlam, BC   (Map)
Person 1:
First Name:    (*)
Last Name:    (*)
Address:     (*)
Apartment: 
City:     (*)
Postal Code:     (*)
Prov./State: 
Country:     (*)
Home Phone:     (*)
Business Phone: 
Mobile Phone: 
Email:     (*)
  I have read and agree with the Terms of Use   (*)
 
 
REGISTRATION INFORMATION
Student First Name:   (*)
Student Last Name:   (*)
Grade:    (*)
Child's School:   (*)
 
Birthdate:      (*)
Age (as of 1-Jan-23):(set based on birth date)
 
Parent/Guardian Name:   (*)
Parent/Guardian Phone Numbers:   (*)
 
Emergency Contact Name:   (*)
Emergency Contact Number:   (*)
Relationship:   (*)
 
Authorize Pick-up List (ex: Friend, Family, Daycare):
1.  [Name, relationship]
2.  [Name, relationship]
3.  [Name, relationship]
 
Sign out: My child has permission to sign themselves out: Yes   No   (*)
Walk home: My child has permission to walk home: Yes   No   (*)
 
Student's Medical #:   (*)
Medical Concerns (medical conditions, behavioural needs, allergies...):
 
PROGRAMS
 Please select all programs for one child. To register another child, please click 'Add Person' at the bottom of the form.
 
MI-S-W1-1: Waitlist:
MI-S-W1-2:
MI-S-W2-1:
MI-S-W2-2:
MI-S-W2-3:
MI-S-W3-1:
MI-S-W4-1:
 
Promo Code:
 
Waiver Information:
I/We agree that our child(ren) will follow all reasonable directions and instructions given by the Program Instructor(s) in connection with the operation of any and all Community Schools Programs offered in School District #43.
I/We release and forever discharge School District #43, school staff, Program Instructors and partners of the Community Schools of and from all manner of actions, claims and demands of whatever nature which result from any accidental injury, loss of expense sustained, arising out of or in any way connected with participation in any Community School program, service or event.
In the event that our child(ren)is/are injured, ill or in need of immediate medical attention and I/we are unable to be contacted, I/we authorize school district staff, Program Instructors and volunteers to seek medical attention on my/our behalf.
 
CODE OF CONDUCT: Community schools programs and/or camps participants will be following School District 43 (Coquitlam) Code of Conduct. Link: School District 43 Code of Conduct or located on www.sd43.bc.ca
 
 
Photograph, Video, Copy Release:
In accordance with the Freedom of Information and Protection of Privacy Act, School District No. 43 (Coquitlam) requires consent to use photographs, videos, copy, names and other information of students, parents, employees, and community members in a variety of publications to promote the school district and its programs and services to the public. This includes newsletters, brochures, newspapers, magazines, reports, websites, social media, radio, television or other communications materials, platforms, and formats.
I hereby consent to and authorize the use of my child’s textual copy, name, voice and physical likeness in photographic, audio, video, hardcopy or electronic reproduction form, in perpetuity, in any communications materials and formats produced by School District No. 43 (Coquitlam) for the use outlined above.
I understand that the choice of which reproduction is to be used, if any, is at the discretion of School District No. 43 (Coquitlam) (or its designated departments) and that the decision would be based on artistic merit, specific design needs and technical requirements.
I also understand that I do not have copyrights to, or legal ownership of, any textual copy or reproductions made and used by School District No. 43 (Coquitlam) and covered by this release.
I also hereby release, discharge and agree to save harmless School District No. 43 (Coquitlam), its trustees, employees, students and all heirs, legal representatives or assignees from any liability, including without limitation, any claims for libel or invasion of privacy.

I give my consent for the Photograph, Video, Copy Release:
Consent for the publication of my child’s photographs/name: Yes   No   (*)
Refund Policy:
A full refund will be given for any cancelled weeks prior to June 2, 2023. Any cancellations after June 2, 2023 will be charged a $25.00 administration fee for each week cancelled. If you cancel during the camp, refunds will not be issued for paper registration (cash and cheque payments) until September when the School Accounting Clerk returns.
By signing below you confirm that all information is correct and that you have reviewed and agree with all waivers and the refund policy.
Signature: Please sign here using your mouse (click and hold the mouse button on PC or Mac) or your finger (on tablet or phone)
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  Send a reminder email a day before
Use the note field to send a message to the organizer, or as a reminder for yourself.
Note:

Please complete the registration details and click 'Confirm' to continue with your payment
or press 'Add Person' to register an additional person

Some options are no longer available. Please either only select WAITLIST options (then you will be added to the waitlist) or only select available options.

  

To change or cancel a registration go to:My Registrations
To make another registration go to:Events