Please list a reference that can attest to your character and suitability to work with children (aside from parent/
caregiver).

Any health concerns/accidents that arise during a camp session must be brought to the immediate attention of the camp Health Care Team. The Health Care Team’s instructions must be strictly followed. While on-site all personal medications, including vitamin supplements, etc..., must be kept under lock and key in the Health Care Office. If you are exposed to a communicable illness in the 2 weeks prior to a camp session, the Registrar must be informed.

A current Criminal Record Check is required (within the last six months) by all PSWs. Please mail your Criminal Record Check (must be the ORIGINAL and include a Vulnerable Sector Search) to:
Attn: Camp Registrar
3981 Oak Street
Vancouver BC
V6H 4H5

I, as the Personal Support Worker of __________________________________ (Child’s Name), and in consideration of the recreational,
educational and health care services provided by the BC Lions Society for Children with Disabilities (hereafter referred to as the ‘BC Lions Society’) agree as follows:
1. I hereby release and discharge the BC Lions Society, Easter Seals, the Custom Service Transit Society and any other respective agents and employees from all manner of action, causes of action, claims or demands I may have, arising from or related to my attendance at camp and/or activities held away from camp. I do however wish to attend a BC Easter Seals Camp, notwithstanding such potential risk.
2. I agree to indemnify the BC Lions Society, its services, agents or employees, from any claims or demands made against the BC Lions Society in respect to any loss or damage which they may suffer or become legally obligated to pay as a result of, or arising from, my attendance at camp.
3. I consent to the administration of my medical treatments as is determined to be necessary by the BC Lions Society, its servants, agents or employees, in their sole discretion, for my health at the camp.
4. I certify that all information provided in this registration form is true and to the best of my knowledge at the time of completing this and for all subsequent camp administrated forms.
5. Please note that the child you accompany will ONLY be released on departure day to the individuals listed on this form (primary contact, emergency contact). The BC Lions Society must be notified IN WRITING of any changes ot the list. Identification is REQUIRED for pick-up.
6. I have reviewed the expectations and policies as outlined throughout this application and I understand that should I breach any of the expected behaviours, myself and the camper attending with me could be asked to leave the camping program immediately. If this occurs, I will be responsible for arranging for my and my camper’s transportation from camp and the associated costs.
7. I agree that I am financially responsible in the case of illness, injury, accident, emergency or property damage resulting from my participation in Easter Seals Camping programs and that the BC Lions Society may claim over against me for any claim which the participant or a third party may make against the BC Lions Society and agree to indemnify and save harmless the BC Lions Society for any expenses reasonably incurred in consequence of the above.

-INFORMATION AND PHOTO WAIVER-
The BC Lions Society reserves the right to take, use and maintain as the property of the Society camper photographs and information
for our promotional materials (print and electronic versions) and to thank donors for their support. Consent for such use is implied
unless the Society is otherwise instructed. Please check the box below if you DO NOT wish that your photo and/or information be used by the Society for the above stated purposes:

I acknowledge that, to the best of my knowledge, the information on the application form is correct. I agree to inform the BC Lions Society of any changes in my medical condition prior to the start of camp. To meet the needs of our campers and have the ability to care for them we must collect personal information about them and distribute this information to people who will care for you and your camper. All the information gathered is stored in a confidential manner. The BC Lions Society is in compliance with the Personal Information Protection Act of BC and the Personal Information Protection and Electronic Documents Act (PIPEDA). We may periodically contact you about Society programs, services, events fundraising or volunteering oportunities. To be removed from this list, please contact us at: (604) 873-1865 1-800-818-4483 or email: info@lionsbc.ca
I understand that this is an application for camp and does not guarantee confirmation. Notification of confirmation will be sent by mail at a later date once all portions of the application have been confirmed as successfully completed.
I HAVE READ AND UNDERSTAND THIS AGREEMENT AND I AM AWARE THAT BY SIGNING THIS AGREEMENT, I AM WAIVING CERTAIN LEGAL RIGHTS WHICH I OR MY HEIRS, NEXT OF KIN, EXECUTORS, ADMINISTRATORS, AND ASSIGNS MAY HAVE AGAINST THE RELEASES.