Before and After Care. ECO Camp at Chimo Before/After Care. ECO Camp at Chimo Bus Transportation ROUTE #4 - THORNHILL SOUTH ROUTE #5 - THORNHILL NORTH

Transcription

1 Eco Chimo is the best camp EVER! - Camper SOUTH Milliken Area Guide W elcome to the 2018 summer camp season. Markham values children and is committed to ensuring that all summer camps focus on safe, inclusive and high quality programs. With a mixture of recreation, culture, and library camps offered in one and two week sessions, you are sure to find a great camp for your child. We look forward to seeing you this summer! Staff The camp staff are chosen for their enthusiasm, creativity and leadership skills. All Recreation and Culture camp staff are qualified in Standard First Aid and HIGH FIVE, and have previous camp experience and leadership skills. HIGH FIVE is a national quality standard for children s sports and recreation. It is designed to promote safety, well-being, and healthy development of children. HIGH FIVE achieves this by providing camp staff with tools, training and resources to support the principles of Healthy Child Development. All Library camp staff are qualified in Standard First Aid with CPR certification. Summer Camp Ratios 6 yrs and under 7 yrs and up Inclusion One to One Support Children with special needs are always welcome at camp. Inclusion counsellors are available to provide one to one support for children in our camp programs. Please speak with the inclusion team to arrange support for your child at x3930 prior to registering using the barcode below corresponding to the week of camp. The deadline to request inclusion support is Friday May 18, After this deadline has passed, our ability to provide one to one support will be subject to availability. Families are welcome to provide their own support. Please note that for the 2018 camp season we have made a change to the one to one inclusion fees. You are no longer required to pay the cost of the camp, where camper ratio and/or equipment are not a factor to participation. You will only need to pay for the one on one inclusion support staff. For the full listing of camps that include the one to one inclusion support fees please visit Markham. ca/summercamps. Campers who would like to register for a camp, that is not on the list of camps that include the one to one inclusion fees, will need to pay for the camp registration fee in addition to the inclusion support. Camp Name Age 1 counsellor : 7 campers 1 counsellor : 10 campers Important Information for Parents Children must be the specified minimum age within the calendar year to attend camp. Children registered must be toilet trained. Campers should wear clothing for indoor and outdoor activities. Parents will receive s throughout the summer. Please call the Contact Centre at if your address is not on file. If swimming is part of the camp, campers will be supervised by counsellors and lifeguards. Campers must be signed in and out of camp each day. Photo ID may be requested. Camp Changes and Transfers Changes and transfers can be made up to the camp start date based on availability. Please see the Refund Policy on page for withdrawal information. Half Day 9:00 a.m. - 12:00 p.m. or 1:00 p.m. - :00 p.m. Full Day 9:00 a.m. - :00 p.m. -17 yrs -17 yrs Day Start Date Jul. 3 Jul. 9 Jul. 16 Jul. 23 Jul. 30 Aug. 7 Aug. 13 Aug. 20 Aug. 27 Jul. 3 Jul. 9 Jul. 16 Jul. 23 Jul. 30 Aug. 7 Aug. 13 Aug. 20 Aug. 27 # of Days Code Fee $210 $262.0 $262.0 $262.0 $262.0 $210 $262.0 $262.0 $262.0 $20 $2 $2 $2 $2 $20 $2 $2 $2 Page 1

2 Before and After This service provides supervision to children before and after their regular camp hours. Activities include board games, cards, puzzles and arts and crafts. Hours Day Day 7:30 a.m. - 9:00 a.m. $2 $30 Before 8:00 a.m. - 9:00 a.m. *at select camps only $16 $20 After :00 p.m. - 6:00 p.m. $32 $0 ECO Camp at Chimo Before/After ECO Camp at Chimo has Before and After available at the following sites: Crosby Arena, Armadale Community Centre and Thornhill Community Centre. Please use the information below to register for Before and After. Note: if you are selecting Before and After, your bus stop should correspond with the appropriate location. Week of Crosby Armadale Thornhill Jul. 3 1 Before 31686/ / /31609 After 31687/ / /31607 Jul Before 31701/ / /31626 After 31699/ / /31612 Jul. 30 Aug. 10 Before 3160/ / / After 31606/ / /31627 Aug Before 3168/ / /3171 After 3168/ / /31719 ECO Camp at Chimo Bus Transportation Busing is mandatory for ECO Camp at Chimo. To register for your bus, simply complete your online camp registration. At checkout, you will be prompted to enter your information for the ECO Camp at Chimo bus. The bus schedule for ECO Camp at Chimo indicates the route number that corresponds with each camp. Children 10 years of age and under MUST BE signed on and off the bus each camp day by a parent or guardian. Each route bus is staffed and supervised by Markham Camp personnel. ECO Camp at Chimo BUS ROUTES A.M. P.M. ROUTE #1 - CENTRAL UNIONVILLE St Monica Child Centrre 8:00 :39 William Berczy P.S. 8:0 :33 Crosby Memorial C.C. 8:10 :22 Central Park P.S. 8:20 :16 Centennial C.C. 8:2 :12 ROUTE #2 - UNIONVILLE - MARKHAM VILLAGE Raymerwood P.S. 8:00 :8 Raymerville Dr & Snider Dr 8:0 : Raymerville Dr & Quarry Stone Dr 8:07 :2 E. T. Crowle P.S. 8:12 :37 Kateri Tekakwitha School 8:17 :32 Reesor Park P.S. 8:20 :30 William Armstrong P.S. 8:2 :2 Markham Village C.C. 8:30 :21 James Robinson Elementary P.S. 8:3 :17 R. H. Crosby P.S. 8:0 :12 ROUTE #3 - MILLIKEN Milliken Mills P.S. 8:00 :9 ECO Camp at Chimo BUS ROUTES A.M. P.M. Harvest Moon Dr. & Putnam Gate 8:0 :6 Aldergrove P.S. 8:10 :1 Armadale C.C. 8:16 :3 Denison St. & Featherstone Ave 8:19 :32 Marydale Ave. & Denison St 8:22 :29 Bussa Rd. & Eastvale Dr. 8:27 :27 Roxbury St. & Chatelaine Dr. 8:32 :22 Legacy Dr. & Rouge Bank Dr. 8:37 :17 ROUTE # - THORNHILL SOUTH Bayview P.S. 8:00 :12 Henderson P.S. 8:0 :0 Thornhill C.C. 8:20 :7 Bayview Fairways P.S. 8:2 : German Mills P.S. 8:30 :39 Flowervale P.S. 8:3 :32 Milliken Mills C.C. 8:2 :10 ROUTE # - THORNHILL NORTH Woodland P.S. 8:00 :7 St Rene Goupil Separate School 8:10 :7 Green Lane & Alexis Rd 8:20 : St Marguerite Bourgeois Sep. School 8:23 :29 Coledale P.S. 8:0 :2 Unionville Public High School 8:0 :19 Unionville Meadows P.S. 9:00 :09 ROUTE #6 - UNIONVILLE NORTH Reflection Rd. & Prince Regent Rd. 8:00 :7 Russell Dawson Rd & Princess Diana Dr. 8:10 :2 Moss Creek Blvd. & Hillmount Rd. 8:1 :7 Cachet Pkwy. & Willow Creek Dr. 8:20 : Prospectors Dr. & Woodgrove Tr. (at Park) 8:2 :37 All Saints Catholic Elementary School 8:30 :31 The Bridle Walk & Bur Oak Ave. 8:33 :28 Stonebridge Dr. & Bur Oak Ave. 8:3 :2 Roy Rainey Ave. & Bur Oak Ave. 8:0 :22 Wismer Public School 8:3 :19 Centennial Community Centre 8:7 :12 ROUTE #7 - MARKHAM EAST David Suzuki P.S. 8:00 :00 Riverwalk Dr & Oakborough Dr 8:0 : Kenilworth Ave & Michelina Terrace 8:10 :0 Cornell Village P.S. 8:17 :3 Colchester St & Whites Hill Ave 8:22 :39 Greensborough P.S. 8:30 :32 Williamson Road & Buir Oak Ave 8:3 :29 Bur Oak Secondary School 8:1 :23 John McCrae P.S. 8: :19 Routes may be delayed due to traffic or weather. * Buses will not be re-routed to previous stops. Page 2

3 Summer Camp Guide 2018 Miliken Area ACTIVITIES OFFERED 3D Modeling and Printing Camp Dive into one the fastest growing STEM fields. This camp will provide a fun and dynamic experience that will allow children to learn how to model and print in 3D. As part of their group projects, participants will have a chance to learn principles of designing and prototyping. Beginner or advanced, this camp is a unique experience to develop the passion and tech-skills of the future. Absolute Sportacular Camp Participants will enjoy a variety of adrenalinefilled activities. Ultimate Frisbee, lacrosse, touch football, volleyball and a recreational swim are part of this extreme experience. This year the camp will celebrate the Pan Am games with the introduction of table tennis and badminton. Adventures in Math and Science Camp Campers investigate concepts in math, science, and nature through activities, games and crafts designed to stimulate their natural curiosity and develop their interest in scientific discovery and sensory exploration. Archery & Rock Climbing Camp Campers will learn basic archery and rock climbing skills at this camp. Throughout the day, campers will also rotate to different activities including games, cooking, crafts and swimming. All activities are onsite in outdoor and indoor spaces. A different way to stay active this summer! Basketball Camp Children will enjoy this fun high energy camp. Campers will learn dribbling, passing, balance, foot work and shooting, along with exploring the positional aspects of the game. A tournament will be held on the last day. Computers, Games & Fun Camp Campers will explore the use of computers for one hour each day and learn how to use a variety of Microsoft software. Also included are games, theme days, special guests, and swimming. ECO Chimo Campers will learn an appreciation for nature at this truly unique outdoor camp. This camp includes weekly rotations of archery, canoeing, arts & crafts, high ropes and swimming at one of the City pools. Also included are nature hikes, outdoor games, theme days, hiking and special guests. Economics Camp Economics is not just money. It s businesses and how they work. Campers will use fun money to buy, sell and trade in their own make believe camp world. Also included are games, special events and swimming. Fun in the Sun - Optional Swim Program Campers registered in the Fun in the Sun camp will learn swimming skills through lessons. We run the Lifesaving Society learn to swim program and will place the campers based on their ability. Fun in The Sun Camp Campers will enjoy a variety of indoor and outdoor activities with a focus on fun, making friends, arts & crafts, sports, games, theme days, special guests and swimming at some locations. Hunger Games Chimo Join us for Hunger Games Chimo focuses on archery, canoeing, ropes, cooking over a camp fire, geocaching and lots of fun games. There is no bussing for this week so drop off your child at the camp. We do have before and after care at the Chimo location for this week. MAKER STEAM Camp Campers will be immersed in a world of creativity and innovation to develop essential 21st century skills. Children will be introduced to the Digital Innovation Hub and makerspaces at the NEW Aaniin Library where they will learn through interactive, hands-on activities in Science, Technology, Engineering, Arts, and Math! My Little Camper Little campers will enjoy a themed week full of fun. They will participate in games, sports, outdoor water play, arts and crafts, and story time. They will also experience a special guest or activity each week! Public Speaking Camp Children will explore fun and interactive activities and games to develop self-confidence, and learn to overcome nervousness. Participants will work on activities to practice speaking and presentation skills in order to become more effective communicators. Participants will prepare and share an inspiring speech as their final project on the last day of camp (presentation will be recorded and shared with parents/guardians via ). Robotics Camp This camp is ideal for those children with interest in robots and remote controls. Every day will feature new robotics themed activities that will be sure to engage and educate in a fun safe environment. This camp includes swimming, sports and crafts. Science and Discovery Camp Explore science through fun, hands-on experiments and weekly themes. Campers participate in a variety of science activities, as well as outdoor play, recreational swimming, sports, and games. Soccer Camp Campers will develop their soccer skills, including ball control, passing and shooting on a daily basis. Also included are games, tournaments, theme days and swimming. Start Up Camp This camp will help the young innovators master fundamental skills of business and be empowered to pursue their own entrepreneurial journey! Campers will gain hands-on experience in innovating and creating a product that addresses real world challenges while gaining critical thinking and team building skills to create their own product using 3D printers, sewing machines, and makerspace resources! Campers will end their week by pitching their idea to a panel of judges STEAM Camp (Science, Technology, Engineering, Arts, Math) New and exciting projects & challenges every week! Get ready with your lab coat, safety goggles, and imagination. The week is filled with hands-on engineering challenges, technology explorations, science experiments, LEGO, robotics, and adventures. Campers will explore using ipads, 3D printers, and other science and tech equipment. Children work in small teams grouped by age on projects that connect all the STEAM subjects. Campers will host a STEAM fair on the last day to celebrate and share their amazing creations with their parents. SuperHero Training Camp From Princess Elsa to Batman, this is the perfect camp for any child who dreams of being a superhero! Superboys and supergirls will be inspired through stories, dramatic play, games and challenges. Children will have the opportunity to design and create their very own superhero ring with the use of our 3D printers! Writer s Workshop Join other students in a relaxed atmosphere and explore a range of writing styles: manga, poetry, mystery, fantasy, plays, fiction and non-fiction. Try them all! Campers will expand their interest in writing and experience writing as a fun and creative opportunity for self-expression and communication. With the guidance of our staff, campers will be able to create their very own digital book which will be presented on the last day of camp! Page 3

4 Location Camp Name Age Start Time # of Days Code Fee Camp Chimo ECO Chimo 6-8 Jul. 3 9:00 a.m. - :00 p.m $ Jul. 16 9:00 a.m. - :00 p.m $36.88 Jul. 30 9:00 a.m. - :00 p.m $ Aug. 13 9:00 a.m. - :00 p.m $ Jul. 3 9:00 a.m. - :00 p.m $ Jul. 16 9:00 a.m. - :00 p.m $36.88 Jul. 30 9:00 a.m. - :00 p.m $ Aug. 13 9:00 a.m. - :00 p.m $ Jul. 3 9:00 a.m. - :00 p.m $ Jul. 16 9:00 a.m. - :00 p.m $36.88 Jul. 30 9:00 a.m. - :00 p.m $ Aug. 13 9:00 a.m. - :00 p.m $36.88 Before Lunch After After /w Swim See ECO Camp at Chimo Before/ After on page <?> for details. Hunger Games Chimo 9-11 Aug. 27 9:00 a.m. - :00 p.m $ Aug. 27 9:00 a.m. - :00 p.m $ Aaniin C.C. Science and Discovery Camp 6-12 Jul. 3 9:00 a.m. - :00 p.m $ Jul. 9 9:00 a.m. - :00 p.m $ Jul. 16 9:00 a.m. - :00 p.m $ Jul. 23 9:00 a.m. - :00 p.m $ Jul. 30 9:00 a.m. - :00 p.m $ Aug. 7 9:00 a.m. - :00 p.m $ Aug. 13 9:00 a.m. - :00 p.m $ Aug. 20 9:00 a.m. - :00 p.m $ Aug. 27 9:00 a.m. - :00 p.m $ Swim Camp 6-12 Jul. 9 9:00 a.m. - :00 p.m $ Jul. 16 9:00 a.m. - :00 p.m $ Jul. 23 9:00 a.m. - :00 p.m $ Jul. 30 9:00 a.m. - :00 p.m $ Aug. 13 9:00 a.m. - :00 p.m $ Aug. 20 9:00 a.m. - :00 p.m $ Aaniin Library 3D Modeling and Printing Camp 9-12 Aug. 7 9:00 a.m. - :00 p.m $ Adventures in Math and Science Camp -6 Jul. 30 9:00 a.m. - :00 p.m $ MAKER STEAM Camp 6-8 Jul. 9 9:00 a.m. - :00 p.m $ Aug. 13 9:00 a.m. - :00 p.m $ StartUp Camp 9-12 Jul. 16 9:00 a.m. - :00 p.m $ STEAM Camp (Science, Technology, Engineering, Arts, Math) 6-8 Jul. 3 9:00 a.m. - :00 p.m $ SuperHero Training Camp -6 Aug. 20 9:00 a.m. - :00 p.m $ Writer s Workshop 9-12 Jul. 23 9:00 a.m. - :00 p.m $ Armadale C.C. Archery & Rock Climbing Camp 7-12 Jul. 3 9:00 a.m. - :00 p.m $ Jul. 9 9:00 a.m. - :00 p.m $ Jul. 16 9:00 a.m. - :00 p.m $ Jul. 23 9:00 a.m. - :00 p.m $ Jul. 30 9:00 a.m. - :00 p.m $ Aug. 7 9:00 a.m. - :00 p.m $ Aug. 13 9:00 a.m. - :00 p.m $ Aug. 20 9:00 a.m. - :00 p.m $ Aug. 27 9:00 a.m. - :00 p.m $ My Little Camper -6 Jul. 3 9:00 a.m. - :00 p.m $ Jul. 9 9:00 a.m. - :00 p.m $ Jul. 16 9:00 a.m. - :00 p.m $ Jul. 23 9:00 a.m. - :00 p.m $ Jul. 30 9:00 a.m. - :00 p.m $ Aug. 7 9:00 a.m. - :00 p.m $ Page

5 Summer Camp Guide 2018 Miliken Area Location Camp Name Age Start Time # of Days Code Fee Before Lunch After Aug. 13 9:00 a.m. - :00 p.m $ Aug. 20 9:00 a.m. - :00 p.m $ Aug. 27 9:00 a.m. - :00 p.m $ M.M. Soccer Dome Absolute Sportacular Camp 9-1 Jul. 16 9:00 a.m. - :00 p.m $ After /w Swim 10-1 Jul. 30 9:00 a.m. - :00 p.m $ Soccer Camp 6-12 Jul. 3 9:00 a.m. - :00 p.m $ Jul. 9 9:00 a.m. - :00 p.m $ Jul. 23 9:00 a.m. - :00 p.m $ Aug. 7 9:00 a.m. - :00 p.m $ Aug. 13 9:00 a.m. - :00 p.m $ Aug. 20 9:00 a.m. - :00 p.m $ Aug. 27 9:00 a.m. - :00 p.m $ Milliken Mills C.C. Basketball Camp 6-9 Aug. 20 9:00 a.m. - :00 p.m $ Aug. 27 9:00 a.m. - :00 p.m $ Aug. 20 9:00 a.m. - :00 p.m $ Aug. 27 9:00 a.m. - :00 p.m $ Computers, Games & Fun Camp 6-10 Jul. 9 9:00 a.m. - :00 p.m $ Jul. 23 9:00 a.m. - :00 p.m $ Jul. 30 9:00 a.m. - :00 p.m $ Aug. 20 9:00 a.m. - :00 p.m $ Economics Camp 8-12 Jul. 16 9:00 a.m. - :00 p.m $ Aug. 7 9:00 a.m. - :00 p.m $ Aug. 13 9:00 a.m. - :00 p.m $ Fun in the Sun - Optional Swim Program -12 Jul. 9 9:30 a.m. - 10:00 a.m $3 Jul. 23 9:30 a.m. - 10:00 a.m $3 Jul. 30 9:30 a.m. - 10:00 a.m $3 Aug. 20 9:30 a.m. - 10:30 a.m $3 Aug. 27 9:30 a.m. - 10:30 a.m $3 Fun in The Sun Camp 6-12 Jul. 3 9:00 a.m. - :00 p.m $ Jul. 9 9:00 a.m. - :00 p.m $ Jul. 23 9:00 a.m. - :00 p.m $ Jul. 30 9:00 a.m. - :00 p.m $ Aug. 20 9:00 a.m. - :00 p.m $ Aug. 27 9:00 a.m. - :00 p.m $ Robotics Camp 6-12 Jul. 3 9:00 a.m. - :00 p.m $ Jul. 16 9:00 a.m. - :00 p.m $ Aug. 7 9:00 a.m. - :00 p.m $ Aug. 13 9:00 a.m. - :00 p.m $ Aug. 27 9:00 a.m. - :00 p.m $ Milliken Mills H.S. Basketball Camp 6-9 Jul. 3 9:00 a.m. - :00 p.m $ Jul. 9 9:00 a.m. - :00 p.m $ Jul. 16 9:00 a.m. - :00 p.m $ Jul. 23 9:00 a.m. - :00 p.m $ Jul. 30 9:00 a.m. - :00 p.m $ Aug. 7 9:00 a.m. - :00 p.m $ Aug. 13 9:00 a.m. - :00 p.m $ Jul. 3 9:00 a.m. - :00 p.m $ Jul. 9 9:00 a.m. - :00 p.m $ Jul. 16 9:00 a.m. - :00 p.m $ Jul. 23 9:00 a.m. - :00 p.m $ Jul. 30 9:00 a.m. - :00 p.m $ Aug. 7 9:00 a.m. - :00 p.m $ Aug. 13 9:00 a.m. - :00 p.m $ Milliken Mills Library Public Speaking Camp 9-12 Jul. 9 9:00 a.m. - :00 p.m $ Writer s Workshop 9-12 Aug. 20 9:00 a.m. - :00 p.m $ Page

6 How to Register Customers need a Client Barcode Number and an Account PIN to register by Internet or phone. If you do not have this information, call the Contact Centre at Online By Phone Drop-off, Mail or in Person * Please call us if you have not received your mail confirmation one week prior to the program start date. * All Registration Forms are processed in random order. In person registrations at your local community centres will begin one day after the registration start date. What if the program I want to take is full? You can opt to be placed on the waitlist for a program if a space becomes available, you will be contacted via phone three times follow the prompts during the call. If you do not take the spot available by 3pm the following business day, the system will move to the next person on the waitlist. Can I transfer or withdraw from a program? Yes, you can. When you advise/request the transfer or withdrawal will determine the valus of any refund you may receive. Please go to for complete information on refunds, and to request a transfer or withdrawal. Program cancellation Cancellation of programs occurs when there are not enough course registrants. Please sign up early to avoid disappointment. If your course is cancelled, we will do our best to place you elsewhere. If no accommodation can be made, a full refund will be issued. Non-residents Non-residents of the City of Markham are welcome in our programs. A non-resident fee of $10 will be applied to all programs and registration will occur after resident registration has begun. Please see the Contents Page for dates. Returned cheques oops! Please note that an administration fee will be charged for returned cheques. Children s Tax Credits As of January 1, 2017, the Children s Activity Tax Credit will no longer be available. The City of Markham no longer identifies if your course is eligible for credits. Financial assistance The City of Markham believes that recreation opportunities should be available to all residents. Residents experiencing financial difficulty may be eligible for assistance. For more information, please call York Region also offers subsidies for children from families with low income to take part in recreation programs and day camps offered by local municipalities. Please visit York.ca/recreationsubsidies or call Access York for more information and to see if you qualify. Program Cancellation/Refund Policy IF you submit a written request to cancel at least five () business days before the start of the first class... IF you submit a written request to cancel less than five () business days before the start of the first class and the day before the program starts... IF you submit a written request to cancel on the first day and up to and including the second class/day*... * your written request must be submitted one (1) day prior to the day of the third class. IF your request is received after the 3rd class... IF we cancel your program prior to the start date... IF we request an applicant be withdrawn due to lack of program compatibility... You will receive a full refund. You will receive a full refund less a $10 administration fee. The administration fee will be waived if you accept a credit on your account. You will receive a pro-rated refund less a $10 administration fee. The administration fee will be waived if you accept a credit on your account. No refund will be issued after the 3rd class/ day of a program. Sorry, no refund. You will receive a full refund. You will receive a refund less fee for classes attended prior to withdrawal request. IF you have registered for Aquatic Leadership, Varley adult programs/workshops, or camps. You must submit a cancellation request five () days prior to the first class for refund. Any credit balances that remain unused on a client account for two (2) years will be cleared.

7 Registration Form NOTICE: To process your registration please ensure that you have funds on your account prior to submitting your form. You can log into your account through EZ Reg or call the Contact Centre to process your payment. PART A: FAMILY INFORMATION Please print clearly ADULT / PARENT / GUARDIAN's Family Name First Name Birth Date M/D/Y Sex M/F Family Address Apt/Unit # Postal Code Markham Milliken Thornhill Unionville Home Phone # * Other: (Please specify) Guardian's Bus. Phone # Guardian's Cell Phone # Are you a new applicant? Yes No Guardian's Bus. Phone # Guardian's Cell Phone # Have you changed addresses? Yes No * addresses will be used for electronic receipts and program information notifications. If you would like to receive these, please check here FAMILY MEDICAL INFORMATION If there is any medical information, special needs, or inclusion support required, Please indicate below. Is the condition life threatening if untreated? Yes No PART B: PARTICIPANT INFORMATION Can be used for more than 1 family member / * IF PROGRAM IS FULL, APPLICANT WILL BE WAITLISTED 1. PARTICIPANT Family Name First Name Birth Date M/D/Y Sex M/F AND / OR 2. PARTICIPANT Family Name First Name Birth Date M/D/Y Sex M/F AND / OR For additional Summer Camp information, please see reverse. PART C: TERMS AND CONDITIONS PAYMENT AND SUBMISSION Payment and submission of this form does not guarantee registration into the selected course. If the course is full or not available, the funds will be returned to the original form of payment or left as a credit on the registrants account. COLLECTION OF PERSONAL INFORMATION The personal information on this form is collected under the authority of the Municipal Act, and will be used for the purpose of program administration (including surveys and mailings) and incidents requiring medical assistance. Questions regarding the collection of personal information should be directed to the Clerk s Department, City of Markham, 101 Town Centre Boulevard, Markham, Ontario at , ext MEDICAL AUTHORIZATION I hereby give permission and consent, on behalf of myself and the above-named person(s) for whom I am in law responsible (the Participant(s) ), to have City staff administer or arrange for any emergency medical care including hospitalization / transportation if necessary, and to the administration of such emergency medical treatments as may be deemed necessary in the circumstances. All participants are responsible for their own medical coverage. WAIVER OF LIABILITY I recognize that participation in the program/activity for which I have registered may include a risk to health or a risk of injury. I, on behalf of myself and the Participant(s), Total Charged hereby willingly assume such health risk or risk of injury, and assume full responsibility before, during and after my/their participation in the program/activity. I, on behalf of myself and the Participants, hereby release, waive and forever discharge the City of Markham, and its elected officials, officers, employees, agents, representatives, volunteers and other participants (the City Indemnitees ) from all liability, claims, demands, losses, damages, costs, actions and other proceedings whatsoever, in respect of death, injury, loss or damage to myself or the Participants, or my/their property, howsoever caused, except to the extent caused by or attributable to the negligent or intentional acts of the City Indemnities, resulting from or connected with participation in any program/activity contemplated by this Registration. By signing below I confirm that I have read, understand and agree to the above terms and conditions. Print Name: Signature: Date: