Learning House Registration - Tsawout First Nation

TLH REGISTRATION

"*" indicates required fields

Step 1 of 9

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REGISTRATION INFORMATION

Please select each program area that you would like for your child(ren).

Program Area*

Tsawout Learning House Registration

Spring Break Camp Registration

Summer Camp Registration

School Year*

Please enter the current school year.

STUDENT INFORMATION

Please complete the following fields for each student.

Additional Student Information

Name	Birthdate	School	Grade	Teacher	Actions

There are no Children.

Maximum number of children reached.

SPRING/SUMMER CAMP PICK-UP INFORMATION

Camp Hours: Monday - Friday from 9:00 am - 3:00 pm
Pre-Care: 8:30 am - 9:00 am
Post-Care: 3:00 pm - 4:00 pm

Time Child(ren) will be picked up:*

Enter time your child(ren) will be picked up by (must before 4:00 pm)

My Child(ren) will be:*

Select if your child(ren) will be picked up, walked home or both.

Picked Up

Walked Home

Name of Person Picking Up

First Last

Phone Number of Person Picking Up

Name of Person Walking Home

First Last

Phone Number of Person Walking Home

PARENT / LEGAL GUARDIAN INFORMATION

Name*

First Last

Address*

Street Address Address Line 2 City Province Postal Code

Home Phone

Work/Cell Phone*

Email*

EMERGENCY CONTACT

List two people we can contact who can take responsibility if you are not available.

Emergency Contact 1*

First Last

Phone*

Emergency Contact 2*

First Last

Phone*

CONSENT FOR PHOTO AND INTERNET USE

Parent Consent for Photographs*

I give permission for the Tsawout SȾÁUTW̱ I,TOTELṈEW̱,ÁUTW̱ “Learning House” to photograph my child(ren) and use the photographs for media purpose.

Yes

Parent / Legal Guardian Initial*

Parent Consent for Internet Use*

I give permission for my child/ren to access the internet at the Tsawout SȾÁUTW̱ I,TOTELṈEW̱,ÁUTW̱ “Learning House”.

Yes

Parent / Legal Guardian Initial*

WAIVER

By checking this box, you are confirming your signature.*

By giving permission for my child/ren to participate in the Tsawout SȾÁUTW̱ I,TOTELṈEW̱,ÁUTW̱ “Learning House” events, workshops and gatherings and Tsawout’s Swim Clubs, I recognize that in the event that my child/ren become become injured, I agree to indemnify and hold Tsawout First Nation, and their staff and volunteers harmless from and against any claim for damages, including any claim based on the allgeged negligence of said parties, that arise from an injury, accident, or harm of any kind to the registered child/ren while participating in any of the Tsawout SȾÁUTW̱ I,TOTELṈEW̱,ÁUTW̱ “Learning House” activities, or any other supervised event.
During Swim Clubs any child 7 years of age or younger has to be accompanied by a family member 19 years of age or older and must be within arms length at all times.

I agree

AUTHORIZATION TO TREAT A MINOR

Consent*

I, the undersigned parent or legal guardian/s of the participant/s named, do hereby authorize and consent to any medical attention for the child/ren in case all efforts have fails to contact me:

Name of Doctor*

Doctor Phone*

RECREATION PROGRAM AND FIELD TRIP ACTIVITIES - Behaviour Contract

By checking this box, you are confirming your signature.*

I agree

BEHAVIOUR CONTRACT
This Behaviour contract is drawn up by the the Tsawout SȾÁUTW̱ I,TOTELṈEW̱,ÁUTW̱ “Learning House” with the intent of managing a fun and safe learning environment for all children and employees who attend and must be signed by both the child and his/her parent or guardian.

- The contract requires the students to maintain respectful, responsible and cooperative behavior during their attendance at the the Tsawout SȾÁUTW̱ I,TOTELṈEW̱,ÁUTW̱ “Learning House” and when engaging in organized activities and field trips.
- The contract requires the student to be safe and to remain with supervisors and within the facilities during program hours and outings.

The accepted rules and procedures that were developed by the students of the the Tsawout SȾÁUTW̱ I,TOTELṈEW̱,ÁUTW̱ “Learning House” are posted within the classrooms. These rules apply to all students entering the the Tsawout SȾÁUTW̱ I,TOTELṈEW̱,ÁUTW̱ “Learning House” Program.
Students who participate in a respectful, responsible, cooperative and safe manner and follow the rules set forth for each day, will be recognized and rewarded.
Students who choose to behave disrespectfully and in an unsafe manner will be dismissed for an agreed period of time from the Tsawout SȾÁUTW̱ I,TOTELṈEW̱,ÁUTW̱ “Learning House”.

CAMP STRIKE SYSTEM

By checking box, parent acknowledges reading Strike System*

I agree

Please be advised the Tsawout Learning House Summer Camp participants and staff will abide by these rules set forth to help keep the children safe
1. NO BULLYING, FIGHTING OR SWEARING
2. Be Respectful of yourself, others, and all public property
3. Be Cooperative with ALL Staff and Youth Leaders
4. ALWAYS Ask your Leader....before leaving your group, ONLY with your Buddy
5. Use Road Safety: Walk on side of road/sidewalk, behind your leader
6. No eating/No drinking on the Bus
In accordance with these rules, staffs have established a “Strike System.” If a camper is “Not LISTENING” and must be spoken to, it will equal 1 strike, (up to 3 strikes/day).
* 3 STRIKES = 1 Day Suspension on the next camp day from T.L.H. Summer Camp
* 3 more STRIKES (Totals 6 Strikes) = 1 Week suspension from T.L.H. Summer Camp
*3 more STRIKES (Totals 9 Strikes) = Dismissal from T.L.H. Summer Camp
Thank you very much for reviewing these expectations with your child/ren and please do not hesitate to contact us if you have any questions or concerns.

HEAD LICE CHECK CONSENT

HEAD LICE CHECKS for all participants of Tsawout Learning House Summer Culture Camp Consent for Tsawout Learning House Coordinator and Tsawout Health Representative to check your child/ren for head lice and request for permission to treat. This will be done 2 times during T.L.H. Summer Camp, after the long weekends.

Select Head Lice Check Choice*

NO, I do not give permission for a Head Lice check. I/or a member of my family will do it prior to my child/ren starting camp in July and August.

YES, I give permission for a head lice check and treatment by Tsawout Staff

YES, I give permission for a head lice check and I will do the treatment myself

Confirmation

Signature*

By signing this registration form, I agree to all the conditions within. I declare this information is true and accurate, to the best of my knowledge.

Today's Date*

MM slash DD slash YYYY

TSAWOUT EDUCATION

TLH REGISTRATION

REGISTRATION INFORMATION

STUDENT INFORMATION

SPRING/SUMMER CAMP PICK-UP INFORMATION

PARENT / LEGAL GUARDIAN INFORMATION

EMERGENCY CONTACT

CONSENT FOR PHOTO AND INTERNET USE

WAIVER

AUTHORIZATION TO TREAT A MINOR

RECREATION PROGRAM AND FIELD TRIP ACTIVITIES - Behaviour Contract

CAMP STRIKE SYSTEM

HEAD LICE CHECK CONSENT

Confirmation