Summer Camp Registration

Youth Registration Form Summer 2024

Apply now online or submit electronically to dianne@campakomak.com OR print registration form; complete clearly; scan and send to business office.

Step 1 of 2

CAMPER INFORMATION
Camper's Name*
First name Last name
Nickname
Age at start of session*
T-Shirt size*
Date of birth*
DD slash MM slash YYYY

(day / month / year)
Number of years attended Ak-O-Mak*
Address*
Street address Address line 2 City State / Province / Region ZIP / Postal Code Country
PARENT/GUARDIAN INFORMATION
Parent or Guardian #1*
E-mail #1*
Home phone #1*
Cell phone #1
Parent or Guardian #2
E-mail #2
Home phone #2
Cell phone #2
who they live with*
Other (Specify)

Dates	Session A (June 26 - Aug 14)	Session B (June 26 - July 23)	Session C (June 26 - July 17)	Session D (July 10 - Aug 14)	Session SP-2 (July 10 - July 23)	Session E (July 24 - Aug 14)	Session F (July 24 - Aug 7)	Session G (Aug 17 - Aug 31)
Regular Price	$9,496.50	$6,108.20	$4,663.50	$7,469.00	$3,370.50	$4,783.50	$3,450.50	$3,257.50
Sibling Discount (per child)	$8,971.50	$5,754.20	$4,388.50	$7,039.00		$4,388.50	$3,165.50	$3,026.75
Medical Insurance Non CDN	$280	$160	$120	$200	$80	$120	$80	$80

Non Canadians add medical insurance to price.

Select a session
Payment Options
$750.00 Deposit due upon registration (non-refundable).
All balance are due May 1st, any new registration submitted after May 1st is due in full.
Payment plans do NOT apply to early bird pricing. Early Bird prices must be paid in full.
Please advise Camp Ak-O-Mak for Girls who is financially responsible for the Camper.*
Other (Specify)
Would you like to give to Camp Ak-O-Mak for Girls Non Profit Fundraising?*
I wish to contribute:
A receipt will be issued for any donations to Camp Ak-O-Mak for Girls Non Profit.
How did you find out about camp?
Other (Specify)
Past Camper (Specify)
Friend (Specify)
Sporting Event (Specify)
Name of the alumni
Consent*
I agree to the Terms And Conditions
- You will receive email acknowledgement within 48 hours of receipt of Registration form during business hours.
- A valid credit card is required to reconcile charges in excess of refundable expense account which may include elective events / activities, associated travel / food, medical expenses, camp store; Airport travel, Rentals and extra items if used. Final processing of the Refundable Expense Account will be completed after camp and a statement of accounting emailed to the parent. Please ensure the camp has a valid email address.
- Refund Policy: Refund (less $750.00 non-refundable deposit) for cancellation by May 1st, 2024. Full refund may be available only for a medical reason with a doctor's note or registration may be transferred to next season. No credit is given for late arrival or early withdrawal. Any refund given will be charged a 5% admin fee if you have paid by credit card.
- Camp is not responsible for lost or stolen property. Avoid sending expensive items and please label all the campers belongings.
- Referral Credit—Families referring a new family that signs up a camper will receive a $100. credit on campers Refundable Expense Account.
- Camp Ak-O-Mak for Girls maintains a code of conduct for the campers and reserves the right to assess a Camper’s behavior, to revise a Camper stay, or to dismiss a Camper early, when it is deemed necessary in the interest of the child and Camp Ak-O-Mak for Girls, No refunds shall be given in these cases. Parents agree to provide full information on Campers in advance.
- I agree Camp Ak-O-Mak is released from liability in connection with medical treatment and unavoidable accidents. Camp Ak-O-Mak has my permission to use necessary medical measures in the event of an emergency. My child has permission to leave the campgrounds with authorized camp staff for scheduled trips and outings. I hereby agree that if I commence any legal proceedings, they will be held only in the Province of Ontario, and I hereby irrevocably submit to the exclusive jurisdiction of the Courts of Ontario.
- Campers must be vaccinated.
- Any additional sporting or out trips to our programming will increase the price of your store account.
Name*
Date*
DD slash MM slash YYYY

(day / month / year)
Additional Comments
Once we have reviewed your application, you will receive an invoice via e-mail to complete payment.
Email
This field is for validation purposes and should be left unchanged.

Summer Camp Registration

Youth Registration Form Summer 2024

Step 1 of 2

CAMPER INFORMATION

PARENT/GUARDIAN INFORMATION

Once we have reviewed your application, you will receive an invoice via e-mail to complete payment.

Links

Information

Phone

Email

Camp Address

Office Address

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