Summer CampRegistration and Payment ($185) per scoutPlease register one scout at a timeScout's InformationFull Name *The Scout's Full NameDate Of Birth *Street Address *Apartment, suite, etcCity *ZIP / Postal Code *Medicare (RAMQ Card)Quebec Government Issued Medicare CardDo not forget to bring the card with the scoutMedicare Number *The Scout's RAMQ Card NumberMedicare Expiry Date *If the scout DOES NOT have a medicare, please check this boxDoes not have a medicare cardMedical HistoryDoes the Scout have any allergies? *YesNoPlease list the allergies belowList all the allergies that the Scout hasDo they have an epipen?YesNoIf they have an epipen, please do not forget to give it to the Unit Leader when checking inIs the Scout taking any medications? *YesNoPlease list all the medication names and dosage that the Scout is taking and any instructions if needed.Does the Scout have any medical history that leaders should know about? *YesNoPlease explain any medical related things the leaders should be aware ofDoes your child experience nighttime bedwetting?YesVery rarelyNoPlease rest assured that any information shared will be treated with the utmost confidentiality and sensitivity. Our aim is to provide appropriate support and resources to those kids during campingsContact InformationIn case of any emergencies, who should we contact?Parent 1 Full Name *Parent 1 Phone Number *Parent 2 Full NameParent 2 Phone NumberEmergency Contact's Full NameEmergency Contact's Phone NumberOther CommentsIf you have any other comments to add, please leave them hereConsent FormsConsent *I, the undersigned, hereby declare and affirm that: I am the parent/legal guardian of the youth named above (hereinafter referred to as "Scout"), who is under my care and responsibility. I hereby consent and give authority to the participation of my Scout in the scheduled youth activities of the Camp, and all other activities which is supervised and customarily associated with its youth group. I hereby declare and affirm that my Scout is physically fit to take part in the Camp's activities and my Scout has no known illness or adverse medical condition that would render him/her unfit to participate therein, other than the information specified in the medical information above. I shall immediately advise the organizers in writing, should I discover any illness, adverse medical condition, or any other physical defect that would render my Scout unfit to participate in the recreational and sporting activities of the Camp. I shall notify the organizers immediately in case I revoke my consent to the Camp for this event.Authorization for Medical Treatment *I understand that in case of medical emergencies involving my Child, I shall be notified right away. In case any of my provided contact information is unreachable, I authorize the organizers to consult any doctor to provide the necessary medical attention to my child.Signature of Parent / Legal GuardianEmail AddressParent EmailCoupon CodeTotal AmountFull Amount to be paid for 1 ScoutTotal Paid CashSave as DraftRegisterSave as DraftPlease do not fill in this field.
