-
C$0
Total
-
Choose all camps that you would like to attend (all days include chores and feeding of the animals) *
-
-
-
GENDER *
-
-
Does your child have friends of the same age attending and you would like them to be put into the same group?
-
-
Please provide brief details of any health or behaviour issues we should be aware of - (i.e. peanut allergies, ADHD, etc.), or if an aide will be attending with your child. If necessary, we will contact you to further discuss the information provided.
-
Please include behaviour patterns, health issues, allergies, medications. Indicate if your child carries an EpiPen, inhaler, etc.
-
CONTACT INFORMATION
-
-
-
-
-
-
-
This address will be used by to send personal correspondence such as registration confirmation and receipts for payments received.
-
Your email address will be used to communicate Butterfield Acres Program information. Butterfield Acres NEVER sells, rents or trades your email information.
-
-
-
-
-
TERMS AND CONDITIONS:
PARENT / GUARDIAN APPROVAL
I / We do hereby acknowledge and agree that the participation of the child, above named, in this program is at our sole risk and liability; moreover, we hereby release and agree to hold harmless and indemnify BUTTERFIELD ACRES INC., its agents, subcontractors and servants or employees or any responsible adult for any and all actions, the causes of action, claims, liabilities and demand whatsoever arising out of or in any way related to or connected with this program without limitation.
ACKNOWLEDGMENT OF RISK
I / We do hereby acknowledge and agree that the participation of the child, above named, in this program is at our sole risk and liability; moreover, we hereby release and agree to hold harmless and indemnify BUTTERFIELD ACRES INC., its agents, subcontractors and servants or employees or any responsible adult for any and all actions, the causes of action, claims, liabilities and demand whatsoever arising out of or in any way related to or connected with this program without limitation.
CONSENT FORM
I / We hereby consent to any medical attention or any other care or treatment considered necessary by the staff of BUTTERFIELD ACRES INC. or other responsible adult.
RELEASE
Further, I / We also grant full permission for any pictures of my child, taken by BUTTERFIELD ACRES INC. employees and / or agents during this camp to be used for promotional purposes providing this child's name is not used.
CHANGE/ADJUSTMENT POLICY
A minimum $20.00 fee will be applied to registration change(s). The exception to this is program additions.
CANCELLATION / REFUND POLICY
Butterfield Acres will refund your camp fee only if a class must be canceled due to lack of registration. Otherwise fees are not refundable. If your camper is unable to attend camp for the day, you may substitute another child (a new registration for is required).
-
I understand this is a legal representation of my signature.
Clear
-
-
-
-
-
SECURE ONLINE REGISTRATION
As with any transmission over the Internet, there is always some element of risk involved in sending personal information. In order to try to minimize this risk, we encrypt all information that you submit using the Secure Socket Layer (SSL) protocol. Our Certificate enables up to 256-bit SSL encryption - the most powerful SSL encryption commercially available today.
If you are ever in doubt, look for the lock - 
- it appears in your web browser window (usually bottom right corner) and/or browser address bar along with the "https://" prefix indicating SSl security is enabled on the current page.
-
CAPTCHA
The purpose of the CAPTCHA image below is to block form submissions by spambots, which are automated scripts that post spam content wherever they can. To confirm you're a human, please...
-
-
C$0
Total
-