Camper Application

Camp Overview

Who can be a camper?: Children going into Sr. Kindergarten (5 years old) up to Grade 6 (11 years old) in fall of 2025

Location: St. George Parish (1164 Commissioners Rd. W., London, ON)

Dates: August 11-15 ( 5 day week)

Time: 9AM-4PM

Cost per week of camp: $120 per camper, up to 4 campers. $80 per camper, after 4 campers

Before & After Care:

- Before care: 8:30AM-9AM

- After care: 4PM-4:30PM

- Cost: $10/day

Financial aid may be available. Please contact us if you require financial assistance.

Springbank Catholic Family of Parishes
Day Camp Application to Register

Parent/Guardian Information

* The Parent/Guardian will also act as the Emergency Contact.

First Name

Last Name

Primary Phone Number

Secondary Phone Number

Relationship to Camper

Email (All camp communications will be sent via email)

Street Address

City

Postal / Zip code

Region/State/Province

Name of Parish that you are regiered at:

Camper Information

First Name

Last Name

Birthday

Health Card Number

Grade in the fall

Physician Name

Physician Phone Number

Medical Information (allergies, medical conditions, etc.)

We strive to host inclusive, accessible activities that all persons can fully engage in. Does your child have any access requirements that we should be aware of?

T-Shirt Size

Youth Small

Youth Medium

Youth Large

Adult Small

During the day, campers may be split into groups based on age. Campers may request to be in a group with one or two other people. If your camper would like to request a group member(s), please list their name(s) below and the Springbank Camp staff will do their best to accomodate your request. If campers are not the same age, it is unlikely that they will be grouped together.

Child 2

*All campers on this form must be under your legal guardianship (i.e. you are their parent, court-appointed guardian, etc.)

First Name

Last Name

Birthday

Grade in the fall

Health Card Number

Physician Name

Physician Phone Number

Medical Information (allergies, medical conditions, etc.)

We strive to host inclusive, accessible activities that all persons can fully engage in. Does your child have any access requirements that we should be aware of?

T-Shirt Size

Youth Small

Youth Medium

Youth Large

Adult Small

Child 3

*All campers on this form must be under your legal guardianship (i.e. you are their parent, court-appointed guardian, etc.)

First Name

Last Name

Birthday

Health Card Number

Grade in the fall

Physician Name

Physician Phone Number

Medical Information (allergies, medical conditions, etc.)

We strive to host inclusive, accessible activities that all persons can fully engage in. Does your child have any access requirements that we should be aware of?

T-Shirt Size

Youth Small

Youth Medium

Youth Large

Adult Small

Before/After Care

Before and after care is available each day of camp for an additional fee of $10/day, up to a total of $50 for the week. Before care is available from 8:30AM until 9AM, and after care is available from 4PM until 4:30PM. Pre-registration, including payment, are required before camp begins. Please check all days that before and / or after care is required.

Payment Summary

How many days of before/after care?

Total: (Number of Weeks of Camp x $120) + (Number of days of before and after care x $10)

Refund Policy

Withdrawal requests received at least two weeks before the first day of Camp will be returned in full. Withdrawal requests received after the first day of camp will will incur a $50 cancellation fee.

I have read, understand, and accept these terms.

Authorized Pickup List

* At least one Primary Pickup Person must be a legal parent/guardian. Individuals who are not listed as primary pickup individuals will be asked for government-issued ID upon arrival.

Primary Pickup Person #1

Relation to Camper

Primary Pickup Person #2

Relation to Camper

Secondary Pickup Person #1

Secondary Pickup Person #2

Acknowledgements and Waiver

Application to Register Summary

Camp applications are not final until a member from our Team has e-mailed to confirm registration, and payment must be received within 2 business days after registration is confirmed in order to guarantee your camper's spot(s). If you do not confirm the spot within 48 hours upon receiving a registration offer, the spot will be offered to the next person on the waitlist.

I have read and understand the Camp application process.

Waiver

Please download and complete the Waiver form by clicking on the "PDF" button to the left of this text. Children who do not have Waivers will not be able to participate in camp. Waivers must be filled out by the camper's legal parent/guardian.

Once you have completed the form, save it on your computer.

Next, please upload your completed Waiver by clicking on the "Upload Waiver" button (left).

Upload Waiver

I hereby acknowldge that all information provided on this form is correct and that I have signed the attached waiver form as a legal parent/guardian of my child(ren).

I give permission for my child(ren) to travel on foot to Springbank Park.

I authorize the use of any photos and videos taken over the duration of camp for promotional purposes in the future.

Parent/Guardian Name

Date

Parent/Guardian Signature

Thank you for submitting an Application to Register! A member of our Team will be in contact within 1-2 business days. Please do not contact the Office to inquire about the status of your application.

Thank you for your interest in Springbank Summer Camp! We are not accepting registrations at this time, Camp is full. You will be automatically added to our Waitlist, and contacted should a spot become available.

Camper Application

Springbank Catholic Family of Parishes Day Camp Application to Register

Springbank Catholic Family of Parishes
Day Camp Application to Register