DAY CAMP APPLICATION 6-8 year olds

C$0

Total

+Tax 5%
DATE OF CAMP *

Check for Day Camp Availability
Age Group and Time
NAME OF CAMPER NAME OF CAMPER * First Last
GENDER *

GENDER Female Male
BIRTHDATE BIRTHDATE * / MM / DD YYYY

To enter your child's birth date, click on the calendar icon to the right - then choose date.
Does your child have friends/siblings attending the same age group and week? List their names here, if you would like them to be in the same group.
Put together with
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.
Special concerns

Please include behaviour patterns, health issues, allergies, medications. Indicate if your child carries an EpiPen, inhaler, etc.
CONTACT INFORMATION
PARENT #1 PARENT #1 * First Last
PARENT #1 - CELL PHONE PARENT #1 - CELL PHONE * - ### - ### ####
PARENT #1 - HOME PHONE PARENT #1 - HOME PHONE - ### - ### ####
PARENT #1 - WORK PHONE PARENT #1 - WORK PHONE - ### - ### ####
PARENT #2 PARENT #2 First Last
PARENT #2 - HOME PHONE PARENT #2 - HOME PHONE - ### - ### ####
PARENT #2 - CELL PHONE PARENT #2 - CELL PHONE - ### - ### ####
PARENT #2 - WORK PHONE PARENT #2 - WORK PHONE - ### - ### ####
HOME ADDRESS HOME ADDRESS *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
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.
PARENT #1 - EMAIL *
PLEASE RE-ENTER YOUR EMAIL
PARENT #2 - EMAIL
PLEASE RE-ENTER SECOND EMAIL
Another week for this child?
How many weeks is your child registered for?
...making life EASIER for Parents... and MORE FUN for campers!
EASY OPTION A - SNACK PROGRAM
Our nutritious camper-friendly snacks - see website for menu items.

My child is in the 6-8 yr old, 6 hour program, and I would like Butterfield Acres to provide the two snacks needed each day: for a 5 day week $34.99 , for a 4-day week $30.99
YES! Register for Farm Snack Program
Snack Program
Are you ordering snacks for a regular 5 day week, or for the 4 day short week (August 8-11)? *

Are you ordering snacks for a regular 5 day week, or for the 4 day short week (August 8-11)? 2 Snacks per day for a 5-day week 2 Snacks per day for a 4-day week
EASY OPTION B - LUNCH PROGRAM

Our nutritious camper-friendly lunches are well balanced, "hot" meals - see website for menu items. *Please be aware some ingredients used for lunches are labeled "may have traces of nuts"*

My child is in the 6-8 yr old, 6 hour program, and I would like Butterfield Acres to provide lunch each day: $59.99 for a 5-day week, $49.99 for a 4-day week
YES! Register for Farm Lunch Program
Lunch Program
Are you ordering lunch for a regular 5 day week, or for the 4 day short week (August 8-11)? *

Are you ordering lunch for a regular 5 day week, or for the 4 day short week (August 8-11)? Lunch day for a 5 day week Lunch day for a 4 day week
EASY OPTION C - BEFORE CAMP CARE PROGRAM

Available 7:30 a.m. - 9:30 a.m.
Cost: $9.29/hr when booked at time of registration. $9.99 when added later.
YES! Register my child for BEFORE CAMP CARE
Before Camp Care
Your child's camp starts at 9:30 am. for this week, you'll need how much time of BEFORE CAMP CARE for how many days?
Please choose carefully from the following dropdown list. This information is used to calculate your BEFORE CAMP CARE fees.
BEFORE CAMP CARE time *

Please make sure you select the right Before Care time so the correct fee is calculated.
To be more specific, I will need BEFORE CAMP CARE on these days:
*

MONDAY Morning TUESDAY Morning WEDNESDAY Morning THURSDAY Morning FRIDAY Morning
Drop off time *
EASY OPTION D - AFTER CAMP PROGRAM

Available until 5:00 p.m.
Cost: $9.29/hr when booked at time of registration. $9.99 when added later.
YES! Register my child for AFTER CAMP CARE
After Camp Care
Your child's camp ends at 3:30 pm. For this week, you'll need how much time of AFTER CAMP CARE for how many days?
Please choose carefully from the following dropdown list. This information is used to calculate your AFTER CAMP CARE fees.
AFTER CAMP CARE time *

Please make sure you select the right After Care time so the correct fee is calculated.
AFTER CAMP CARE is required on these days:
*

MONDAY afternoon TUESDAY afternoon WEDNESDAY afternoon THURSDAY afternoon FRIDAY afternoon
Pickup Time *
EASY OPTION E - DAY CAMP BUS PROGRAM

Available two weeks this summer:
July 17-21 and August 14-18.
Stops at South Centre`s Fish Creek Library and on the south side of Calgary Arts Academy (former Knob Hill School) just East the corner of Richmond Road and 19 Ave SW. More details with your confirmation.

DAY CAMP BUS FARE:
"ONE WAY" bus ride TO, OR FROM, camp is $39.99/week per camper.
"RETURN" bus ride TO AND FROM camp is $49.99/week per camper.

Before Camp Care will be provided to morning bus riders free of charge if their camp does not start until 9:30.
YES! Please register my child for the bus.
Bus Program
ONE WAY or RETURN
MORNING BUS

Please choose the location and time where the Butterfield Acres Bus will pick up your child for a bus ride TO Butterfield Acres.
MORNING BUS PICKUP
WHO will be driving the camper
TO the bus in the MORNING?
First and last NAME
of PRIMARY morning driver
CELL NUMBER
of PRIMARY morning driver CELL NUMBER
of PRIMARY morning driver - ### - ### ####
First and last NAME
of SECOND (or alternate) morning driver
CELL NUMBER
of SECOND (or alternate) morning driver CELL NUMBER
of SECOND (or alternate) morning driver - ### - ### ####
AFTERNOON BUS

Please choose the location and time where you will meet the Butterfield Acres Bus to pick up your child AFTER Day Camp.
AFTERNOON BUS DROP OFF
WHO WILL MEET THE AFTERNOON BUS
TO PICK UP YOUR CAMPER?
First and last NAME
of PRIMARY afternoon driver
CELL NUMBER
of PRIMARY afternoon driver CELL NUMBER
of PRIMARY afternoon driver - ### - ### ####
First and last NAME
of SECOND (or alternate) afternoon driver
CELL NUMBER
of SECOND (or alternate) afternoon driver CELL NUMBER
of SECOND (or alternate) afternoon driver - ### - ### ####
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 week, you may substitute another child for the week (a new registration for is required) or you may switch to another week if:
a) that week is earlier than your originally booked week or
b) if that week is later than your originally booked week AND there is at least 30 days before your original camp is to start.

I have thoroughly read, and agree, to the terms and conditions.
*

I Agree
DateSigned DateSigned * / MM / DD YYYY
Signature *

Draw or Type

I understand this is a legal representation of my signature. Clear

Full Name

I understand this is a legal representation of my signature.
Name on the credit card you will be using for payment:
SECURE ONLINE REGISTRATION

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Type the letters you see in the image below.

DAY CAMP APPLICATION 6-8 year olds

DAY CAMP APPLICATION 6-8 year olds

C$`0`

Total

+Tax 5%

Does your child have friends/siblings attending the same age group and week? List their names here, if you would like them to be in 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.

CONTACT INFORMATION

Another week for this child?

...making life EASIER for Parents... and MORE FUN for campers!

EASY OPTION A - SNACK PROGRAM
Our nutritious camper-friendly snacks - see website for menu items.

YES! Register for Farm Snack Program

EASY OPTION B - LUNCH PROGRAM

Our nutritious camper-friendly lunches are well balanced, "hot" meals - see website for menu items. Please be aware some ingredients used for lunches are labeled "may have traces of nuts"

YES! Register for Farm Lunch Program

EASY OPTION C - BEFORE CAMP CARE PROGRAM

Available 7:30 a.m. - 9:30 a.m.
Cost: $9.29/hr when booked at time of registration. $9.99 when added later.

YES! Register my child for BEFORE CAMP CARE

Your child's camp starts at 9:30 am. for this week, you'll need how much time of BEFORE CAMP CARE for how many days?
Please choose carefully from the following dropdown list. This information is used to calculate your BEFORE CAMP CARE fees.

To be more specific, I will need BEFORE CAMP CARE on these days:

EASY OPTION D - AFTER CAMP PROGRAM

Available until 5:00 p.m.
Cost: $9.29/hr when booked at time of registration. $9.99 when added later.

YES! Register my child for AFTER CAMP CARE

Your child's camp ends at 3:30 pm. For this week, you'll need how much time of AFTER CAMP CARE for how many days?
Please choose carefully from the following dropdown list. This information is used to calculate your AFTER CAMP CARE fees.

AFTER CAMP CARE is required on these days:

EASY OPTION E - DAY CAMP BUS PROGRAM

YES! Please register my child for the bus.

MORNING BUS

WHO will be driving the camper
TO the bus in the MORNING?

AFTERNOON BUS

WHO WILL MEET THE AFTERNOON BUS
TO PICK UP YOUR CAMPER?

SECURE ONLINE REGISTRATION

CAPTCHA

DAY CAMP APPLICATION 6-8 year olds

DAY CAMP APPLICATION 6-8 year olds

C$0

Total

+Tax 5%

Does your child have friends/siblings attending the same age group and week? List their names here, if you would like them to be in 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.

CONTACT INFORMATION

Another week for this child?

...making life EASIER for Parents... and MORE FUN for campers!

EASY OPTION A - SNACK PROGRAM Our nutritious camper-friendly snacks - see website for menu items.

YES! Register for Farm Snack Program

EASY OPTION B - LUNCH PROGRAM Our nutritious camper-friendly lunches are well balanced, "hot" meals - see website for menu items. *Please be aware some ingredients used for lunches are labeled "may have traces of nuts"*

YES! Register for Farm Lunch Program

EASY OPTION C - BEFORE CAMP CARE PROGRAMAvailable 7:30 a.m. - 9:30 a.m. Cost: $9.29/hr when booked at time of registration. $9.99 when added later.

YES! Register my child for BEFORE CAMP CARE

Your child's camp starts at 9:30 am. for this week, you'll need how much time of BEFORE CAMP CARE for how many days? Please choose carefully from the following dropdown list. This information is used to calculate your BEFORE CAMP CARE fees.

To be more specific, I will need BEFORE CAMP CARE on these days:

EASY OPTION D - AFTER CAMP PROGRAM Available until 5:00 p.m. Cost: $9.29/hr when booked at time of registration. $9.99 when added later.

YES! Register my child for AFTER CAMP CARE

Your child's camp ends at 3:30 pm. For this week, you'll need how much time of AFTER CAMP CARE for how many days? Please choose carefully from the following dropdown list. This information is used to calculate your AFTER CAMP CARE fees.

AFTER CAMP CARE is required on these days:

EASY OPTION E - DAY CAMP BUS PROGRAM

YES! Please register my child for the bus.

MORNING BUS

WHO will be driving the camper TO the bus in the MORNING?

AFTERNOON BUS

WHO WILL MEET THE AFTERNOON BUS TO PICK UP YOUR CAMPER?

SECURE ONLINE REGISTRATION

CAPTCHA

C$`0`

EASY OPTION A - SNACK PROGRAM
Our nutritious camper-friendly snacks - see website for menu items.

EASY OPTION B - LUNCH PROGRAM

Our nutritious camper-friendly lunches are well balanced, "hot" meals - see website for menu items. Please be aware some ingredients used for lunches are labeled "may have traces of nuts"

EASY OPTION C - BEFORE CAMP CARE PROGRAM

Available 7:30 a.m. - 9:30 a.m.
Cost: $9.29/hr when booked at time of registration. $9.99 when added later.

Your child's camp starts at 9:30 am. for this week, you'll need how much time of BEFORE CAMP CARE for how many days?
Please choose carefully from the following dropdown list. This information is used to calculate your BEFORE CAMP CARE fees.

EASY OPTION D - AFTER CAMP PROGRAM

Available until 5:00 p.m.
Cost: $9.29/hr when booked at time of registration. $9.99 when added later.

Your child's camp ends at 3:30 pm. For this week, you'll need how much time of AFTER CAMP CARE for how many days?
Please choose carefully from the following dropdown list. This information is used to calculate your AFTER CAMP CARE fees.

WHO will be driving the camper
TO the bus in the MORNING?

WHO WILL MEET THE AFTERNOON BUS
TO PICK UP YOUR CAMPER?