Day Camp

* Note that wearing a life jacket is OBLIGATORY for ALL children when they swimming at the cultural site, if they has no life jacket or he refuse to wear it, he can't swim, for his safety.

Person to contact in case of emergency

As a parent, I take the responsibility to inform the day camp animators and/or community organizer, in person, by mail, by phone or by a note, of the absence of my child a day or the delay cause the animators must provides activities and transport as the number of children.

people authorized to pick up the child other than the child's parents

Last and first name *

Please check the week your child will attend *

Parents identification

Authorizations

I authorized the Val-d'Or Native Friendship Center employees to give to my child, if necessary, some medication without prescription. *

Yes No

I authorize the day camp animators to ensure that my child receives all necessary care. I also authorize them to transport my child by ambulance or other wise (at my expense) and him admitted to a health facility. In case of emergency or if you can't reach us, I authorize the doctor to provide all medical care required by his condition, including surgery, transfusion, injections anesthesia, hospitalization, etc. *

Yes No

In order to help the Mohiganech day camp to promote their services, I authorize the day camp employees to use the pictures or videos taken of my child during the day camp. These pictures or videos may be used to produce promotional tolls for the Val-d'Or Native Friendship Center *

Yes No

I accept that my child uses the Center's transportation and taxi 24 for the Mohiganech day camp outing activities. *

I agree

The Val-d’Or Native Friendship Center can’t be liable for any loss, theft or accidents.
Having read all the information, I authorized my child to participate at the day camp at the Native Friendship Center.

YOuth Action

Inscription form Mohiganech Day camp

Kinder garden to Grade 6

Person to contact in case of emergency

people authorized to pick up the child other than the child's parents

Parents identification

Authorizations