Register

  • When: Wednesday, August 8, 2018

    Time: 10 a.m. to 2 p.m.

    Location: Lambton College Courtyard

    Registration Form

    Participant's Information

    Parent/Guardian's Information

      
      

    Medical Information

     
     
       
     

    Parent/Guardian Consent

     

    Being the parent/guardian of the above-named participant who is enrolled in Camp2CONNECT, I hereby give my consent and agree to the following:

    A: EMERGENCY MEDICAL TREATMENT

    In the event of an accident or illness involving the participant, I hereby authorize, if I am not immediately available, the administration of any medical procedures deemed necessary. I also give my permission for the participant to be examined by the College Nurse or transported to the Emergency Department of the hospital, with no liability on the driver’s part. I understand that I cannot hold Lambton College responsible for any injury or illness and will assume responsibility for expenses incurred with any emergency treatment.

    B: AUTHORIZATION FOR PUBLICITY

    The participant may appear in any publicity arranged for by Lambton College through the various media, newspaper, radio, television, photographs or digital screening, slide presentations and other publications.

    C: SUPPORT PERSON/STAFF/GUARDIAN/PARENT:

    The participant will have a support person/staff/guardian/parent with him or her at all times during this camp day. DSW students and faculty will be on-site and they will be responsible for organizing and facilitating the activities.

    D: I AUTHORIZE RELEASE OF THE PARTICIPANT TO/EMERGENCY CONTACT:

    Emergency Contact 1

    Emergency Contact 2

    If I wish anyone other than myself or those listed above to pick up the participant, I will notify the DSW faculty of my intentions.

    I, , have agreed to the above information.

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