Registration LR1

Boomerang Day Camp 2026 Registration Form
Little Roos 1 July 7-11, 2026 (ages 5-7)

Harmony Baptist Church is collecting and retaining this personal information for the purpose of enrolling your child in Boomerang Day Camp. This information will be maintained permanently, as it is a requirement of our insurance company and legal counsel. If you wish Harmony Baptist Church to limit the information collected, or to view your child's information, please contact us.

* Indicates required field

Camp you are registering for: *

Little Roos 1 July 6-10, 2025 (ages 5-7)

During the week of camp, photos/videos will be taken of campers as they participate in the various camp activities. These will be used to create a DVD for each camper as well to promote the activities of Boomerang Day Camp and Harmony Baptist Church. Do you give permission for your child to be photographed or videotaped? *

yes no

Camper Information

Name *

First

Last

Birthdate *

Age as of the first day of camp *

Address:

Street *

City *

Postal Code *

Health Card Number *

Contact Information

#1 Parent/Guardian Name *

First

Last

Phone Number *

Email address *

#2 Parent/Guardian (Optional) *

First

Last

Phone Number *

Email address *

Alternate Emergency Contact Name *

First

Last

Phone Number *

Please list the full names of any other people you will allow to drop-off/pick-up your child from camp. For the safety of the campers, staff will only release campers to those on this list with valid photo ID. *

More Camper Information

Please list any allergies or medical conditions and any prescribed medications such as inhalers, Epi Pens. *

Please list any dietary restrictions for medical or religious reasons. *

Please list any physical, emotional or behavioural concerns or limitations that our staff should be made aware of. *

Liability Release and Informed Consent
Please read carefully the information below before submitting the registration form.
I understand that this is a legal agreement and by submitting the registration form, I freely understand and accept that I am giving up certain legal rights. I am aware of and agree to allow my child to participate in the indoor and outdoor activities as part of the day camp. I understand that there are risks involved with participating in indoor and outdoor games and that injury could result. I freely and fully accept all risks, damages, dangers and hazards, and the possibility of personal injury.

In the event of an emergency, I understand that it may be necessary to obtain medical treatment/administer first aid and/or transport my child to a medical facility and hereby grant my consent to Harmony Baptist Church operating as Boomerang Day Camp to transport my child to the nearest medical facility and assume full liability for any costs related to the treatment and transportation of my child.

I hereby release, indemnify, and hold harmless Harmony Baptist Church operating as Boomerang Day Camp and its directors, corporation members, staff, agents, volunteers, members and representatives from: a) any personal injury, accident or damage to the above named child or his/her property; b) any claims, demands, actions and costs for any loss, injury, damage or expense whatsoever that might arise due to the above named child’s participation in the activities; and c) any and all liability for any damage to the personal property of or personal injury to, any third party resulting from the above named child’s participation in the activities.

I understand that this is a legal agreement that is bound upon my heirs, executors, my administrators, successors, assigns, and myself. I acknowledge that I have read and understand the terms of this agreement and acknowledge that by submitting this form I am voluntarily agreeing to abide by its terms and conditions and I am waiving certain legal rights that my child or I may have.

I have read and I accept the terms of this release. *

Yes

Cancellation Policy
To receive a full refund, notification of cancellation must be received at least 21 days before the start of the week of camp. No refund will be issued with less than 21 days notification. No partial refunds will be issued for missed days of camp, regardless of the reason including illness or dismissal due to disciplinary action.

I have read and accept the terms of cancellation policy *

Yes

Name of person submitting this form *

I would be interested in receiving information about future camps and events at Harmony via email. *

yes no

Prior to the start of camp, you will be sent a detailed schedule of events.

Submit and pay

Boomerang Day Camp 2026 Registration FormLittle Roos 1 July 7-11, 2026 (ages 5-7)

Camper Information

Address:

More Camper Information

Boomerang Day Camp 2026 Registration Form
Little Roos 1 July 7-11, 2026 (ages 5-7)