harvestyouthservices@gmail.com
647.704.1051
#49, Milford Avenue , North York Ontario Unit 2
Home
About HYSI
Services & Programs
Homework Club
Summer Camps
Workshops
Counselling
Contact
Gallary
Home
About HYSI
Services & Programs
Homework Club
Summer Camps
Workshops
Counselling
Contact
Gallary
Summer Camp Registration Form
We’re excited to have your child join us for an engaging, safe, and fun summer experience! Please complete the form below to secure your spot.
Camper Information
First Name
Last Name
Date of Birth
Age
Gender
Home Address
School Currently Attending
Parent/Guardian Information
Parent/Guardian Full Name(s)
Relationship to Camper
Phone Number (Primary)
Phone Number (Secondary)
Email Address
Emergency Contact Name & Phone Number
Health & Safety Information
Does your child have any allergies? (Food, environmental, medication)
Please list all allergies and required accommodations:
Does your child have any medical conditions we should be aware of?
Is your child currently taking any medication? If yes, please provide details:
Does your child require any additional support (behavioral, emotional, physical)?
Authorized Pick-Up
Please list individuals authorized to pick up your child:
Name
Relationship to Camper
Phone
Camp Selection
Select Week(s) Attending
Week 1
Week 2
Week 3
Week 4
Week 5
Week 6
Media Release (Optional but Recommended)
I give permission for my child to be photographed and/or recorded during camp activities for promotional purposes (website, social media, etc.).
Yes
No
Informed Consent & Waiver
By registering, I acknowledge and agree to the following:
I confirm that all information provided is accurate and complete.
I understand that participation in camp activities involves some level of physical activity and inherent risk.
I give permission for my child to participate in all supervised camp activities.
In the event of an emergency, I authorize camp staff to seek medical attention for my child if I cannot be reached.
I agree to inform the camp of any changes to my child’s health or personal information prior to attendance.
I understand and agree to the camp’s policies, including behavior expectations and pick-up procedures.
Signature
Parent/Guardian Full Name
Signature (digital or typed)
Phone
Final Step
By submitting this form, you are confirming your child’s registration for summer camp. A confirmation email will be sent with additional details.
Submit
