Indoor sports include: soccer, flag football, ultimate frisbee, soccer baseball, dodgeball,. European handball and more.
9 WEEKS OF CAMPS TO CHOOSE FROM:
WEEK 1: July 2 - 6 WEEK 2: July 9 - 13 WEEK 3: July 16 - 20 WEEK 4: July 23 - 27 WEEK 5: July 30 - Aug 3 WEEK 6: August 6 - 10 WEEK 7: August 13 - 17 WEEK 8: August 20 - 24 WEEK 9: August 27 - 31
DETAILS
FULL DAYS 9am - 4pm
5-day Camps running July through August Indoor sports include: soccer, flag football, ultimate frisbee, soccer baseball, dodgeball, European handball and more Outdoor sports include: basketball, beach volleyball, ball hockey, water activities and more Lunch Plan available ($45+tax extra) FREE extended care Early 8am drop off, Late pick-up at 4 to 5pm
PRICING
Per week, per child, +tax
1 week: $199 2+ weeks: $185 5+ weeks: $175 8+ weeks: $165
Registration forms are available online at
.12
or at the Burloak Sports Centre.
Half Day Camps also available - please inquire
Contact us @ 905-631-0000 ext. 200 or
[email protected]
REGISTRATION FORM
(Please print)
Once completed, please fax to 905-631-0001 or drop off at Burloak Sports Centre (952 Century Dr., Burlington, ON L7L 5P2)
MULTI-SPORT CAMPS - SUMMER 2018 Participant’s Name: Parent/Guardian Name: Address: City:
Province:
Postal Code:
Home Phone:
Work Phone:
Participant’s Date of Birth (yyyy/mm/dd):
/
/
Sex:
Male
Female
E-mail: Allergies, Medication Concerns, or special needs that we should be aware of: Participant’s Health Card Number: Emergency Contact Information Emergency Contact:
Relationship to Child:
Emergency Contact Number: Parent/Guardian Consent All participants must be signed out from camp by an authorized person. Please identify ALL individuals who can sign out your child. Name:
Relationship to Child:
Name:
Relationship to Child:
Name:
Relationship to Child:
Which week(s) are you registering for?: Week 1: July 2 - 6 Week 4: July 23 - 27 Week 2: July 9 - 13 Week 5: July 30 - Aug 3 Week 3: July 16 - 20 Week 6: August 6 - 10
Per Week Pricing (All-in):
1 week: $225.00
2+ weeks: $209.05
Would you like to sign up for the Lunch Plan?: Payment Options:
Cash
Credit Card #:
Week 7: August 13 - 17 Week 8: August 20 - 24 Week 9: August 27 - 31
5+ weeks: $197.75
Yes (Add $50.85 per week)
No
Cheque (Payable to Conacher Athletics Club) Expiry:
8+ weeks: $186.45
Visa
MasterCard
/
REGISTRATION CANCELLATIONS ARE SUBJECT TO A $25 SERVICE CHARGE. THE UNDERSIGNED IS RESPONSIBLE FOR THE CONDUCT OF THE PLAYER WHILE PARTICIPATING IN THIS PROGRAM. THE PLAYER SHALL BE GOVERNED BY THE RULES ESTABLISHED BY 2212336 ONTARIO LIMITED. MISSED CLASSES WILL NOT BE REIMBURSED. IT IS UNDERSTOOD THAT THE UNDERSIGNED PERSON OF LEGAL AGE OR LEGAL GUARDIAN SHALL NOT HOLD 2212336 ONTARIO LIMITED OR THEIR INSTRUCTORS, ADMINISTRATORS, OFFICIALS, OR THE FACILITY USED LIABLE IN THE EVENT OF INJURY OR LOSS IN ANY MANNER WHATSOEVER. I SPECIFICALLY WAIVE, GIVE UP AND RELEASE 2212336 ONTARIO LIMITED, ITS RELATED COMPANIES AND THEIR STAFF FROM ALL LIABILITY FOR ANY CLAIM FOR DAMAGES WHICH I MAY HAVE RELATING TO INJURIES OR ILLNESS THAT MY CHILD MAY SUSTAIN. BY SIGNING THIS WAIVER, I ALSO CERTIFY THAT MY CHILD IS IN GOOD HEALTH, WITH NO CHRONIC ILLNESS OR ABNORMAL TENDENCIES. THE PLAYER LISTED ABOVE IS REGISTERED UNDER THE CARE OF THE UNDERSIGNED AND ASSUMES ALL RISKS THROUGH ENROLLMENT IN THIS PROGRAM WHICH CONSISTS OF PHYSICAL INTERACTION CAPABLE OF INJURY. THE PLAYER MUST WEAR ALL APPROVED SOCCER EQUIPMENT INCLUDING SHIN PADS. I HAVE READ AND UNDERSTAND ALL ITEMS ON THIS PLAYER FORM. I UNDERSTAND THAT I AM PERMITTING 2212336 ONTARIO LIMITED TO USE MY EMAIL ADDRESS FOR COMPANY-RELATED COMMUNICATIONS. I THE UNDERSIGNED AGREE TO ALLOW 2212336 ONTARIO LIMITED AND/OR ITS RELATED COMPANIES TO USE THE PARTICIPANTS’ NAMES AND OR PICTURES FOR ADVERTISING PURPOSES.
Parent/Guardian Signature:
Date:
