Community Roots Day Camp in Herring Cove • Anglican Diocese of Nova Scotia and Prince Edward Island

Applying discount...

Is this person a volunteer or a camper? *

Volunteer

Camper

What do they like to be called? *

How old is the camper? *

Our camp is for campers ages 6 to 12. Would you like to request an exception for this child to participate?

Yes

Our camp is for ages 6 to 12. Would this individual be interested in volunteering at camp instead?

Yes

How old are you?

Youth (13 to 18)

Adult (19+)

Tip: Note: Youth volunteers don't count toward the leader:camper ratio

Have they been to a daycamp before? *

Yes

What email address should we use to get in touch with you? *

Complete mailing address

What is the best way to contact you?

Phone

Text

Can we contact you by text message through our registration system to share information about camp? *

Yes

Can we share your child's name and contact information with the church hosting the camp so that they can stay in touch with you? *

Yes

Do we have your permission to include your name and phone number in the volunteer handbook for camp volunteers?

Yes

If a nearby parish also hosts a Community Roots Day Camp, are you open to being "on call" for their camp in case they have any volunteers unable to participate at the last minute?

Yes

Can we share your name and contact information with other youth and family ministry programs in the Diocese of Nova Scotia & Prince Edward Island so that they can get in touch with you about other events?

Yes

Healthcard Number and Expiry Date *

Does your child have any physical, mental, emotional or behavioural conditions that may impact their participation in camp? *

Yes

Do you have any physical, mental, emotional or behavioural conditions that may impact your participation in camp?

Yes

Please give us some details about how to best support your camper:

Please give us some details about how to best support you:

Does the camper receive in-class support during the school year? *

Yes

Tip: This may include anything in an IPP such as an education assistant, shortened instructional times, etc. Please note that we don't have the capacity to provide one-on-one support for campers, but are happy to work with families to find ways to support their camper's participation in our program.

Please describe the support that they reeive:

Are there any restrictions on their physical activities? *

Yes

Are there any restrictions on your physical activities?

Yes

Please describe them:

Do they take any medication? *

Yes

Do you take any medication?

Yes

Please list the medication(s), dose(s), frequency and purpose of the medications:

Do they have any allergies or dietary restrictions? *

Yes

Do you have any allergies or dietary restrictions?

Yes

Please list any allergens and the severity of the reactions and/or details of any dietary needs:

Emergency Contact Name *

Relationship to Camper *

Relationship to you:

Emergency Contact Name

Relationship to Camper

Emergency Contact Phone Number

Tell us about your past and/or present involvement in children's ministry: *

Why are you interested in volunteering for Community Roots Day Camp? *

Are you screened to work with children in your parish? *

Yes

Unsure

Tip: Screening requirements vary from parish to parish, but generally are a combination of policy records checks, reference checks, and training. Note: Additional training will be required for all Community Roots Day Camp volunteers.

What particular areas of camp are you interested in? *

Do you plan to be there all day every day? *

Yes

Sunday

Afternoon

Evening

Neither

Monday

Morning

Afternoon

Neither

Tuesday

Morning

Afternoon

Neither

Wednesday

Morning

Afternoon

Neither

Thursday

Morning

Afternoon

Neither

Friday

Morning

Afternoon

Evening

Not available

Is there anything else that you think we should know about your child?

Is there anything else that you want us to know?

Is this person a volunteer or a camper? *

Volunteer

Camper

What do they like to be called? *

How old is the camper? *

Our camp is for campers ages 6 to 12. Would you like to request an exception for this child to participate?

Yes

Our camp is for ages 6 to 12. Would this individual be interested in volunteering at camp instead?

Yes

How old are you?

Youth (13 to 18)

Adult (19+)

Tip: Note: Youth volunteers don't count toward the leader:camper ratio

Have they been to a daycamp before? *

Yes

What email address should we use to get in touch with you? *

Complete mailing address

What is the best way to contact you?

Phone

Text

Can we contact you by text message through our registration system to share information about camp? *

Yes

Can we share your child's name and contact information with the church hosting the camp so that they can stay in touch with you? *

Yes

Do we have your permission to include your name and phone number in the volunteer handbook for camp volunteers?

Yes

If a nearby parish also hosts a Community Roots Day Camp, are you open to being "on call" for their camp in case they have any volunteers unable to participate at the last minute?

Yes

Healthcard Number and Expiry Date *

Does your child have any physical, mental, emotional or behavioural conditions that may impact their participation in camp? *

Yes

Do you have any physical, mental, emotional or behavioural conditions that may impact your participation in camp?

Yes

Please give us some details about how to best support your camper:

Please give us some details about how to best support you:

Does the camper receive in-class support during the school year? *

Yes

Please describe the support that they reeive:

Are there any restrictions on their physical activities? *

Yes

Are there any restrictions on your physical activities?

Yes

Please describe them:

Do they take any medication? *

Yes

Do you take any medication?

Yes

Please list the medication(s), dose(s), frequency and purpose of the medications:

Do they have any allergies or dietary restrictions? *

Yes

Do you have any allergies or dietary restrictions?

Yes

Please list any allergens and the severity of the reactions and/or details of any dietary needs:

Emergency Contact Name *

Relationship to Camper *

Relationship to you:

Emergency Contact Name

Relationship to Camper

Emergency Contact Phone Number

Tell us about your past and/or present involvement in children's ministry: *

Why are you interested in volunteering for Community Roots Day Camp? *

Are you screened to work with children in your parish? *

Yes

Unsure

What particular areas of camp are you interested in? *

Do you plan to be there all day every day? *

Yes

Sunday

Afternoon

Evening

Neither

Monday

Morning

Afternoon

Neither

Tuesday

Morning

Afternoon

Neither

Wednesday

Morning

Afternoon

Neither

Thursday

Morning

Afternoon

Neither

Friday

Morning

Afternoon

Evening

Not available

Is there anything else that you think we should know about your child?

Is there anything else that you want us to know?

Date & Time

Volunteer 0

Camper Basic Information

Basic Information

Please do not complete this registration form.

Please complete the rest of this registration form. We will review the registration and get back to you with a decision within a few days.

Please email campadmin@nspeidiocese.ca for details about how to register as a youth volunteer.

Please do not submit this registration form.

Contact Information

Permissions

Health, Medical, and Personal Support Information

Emergency Contact Information

Backup Emergency Contact

Your Ministry

What is your availability during the week of camp?

Anything Else?

Camper 0

Camper Basic Information

Basic Information

Please do not complete this registration form.

Please complete the rest of this registration form. We will review the registration and get back to you with a decision within a few days.

Please email campadmin@nspeidiocese.ca for details about how to register as a youth volunteer.

Please do not submit this registration form.

Contact Information

Permissions

Health, Medical, and Personal Support Information

Emergency Contact Information

Backup Emergency Contact

Your Ministry

What is your availability during the week of camp?

Anything Else?