CHILD'S INFORMATION

    CONTACT INFORMATION

    IMPORTANT FINANCIAL ASSISTANCE INFORMATION

    Social Assistance Recipients:
    If you are on social assistance, you need to apply IMMEDIATELY for your child's camp fee to be covered. Instructions and a downloadable letter are available on our SuperKids Camp page where the camp registration link is. If, after you have applied to social services and have given them enough time to process your request, you are denied, we will then consider an Extreme subsidy for your child. Written proof of the denial from social services is required.

    Low Income Single Parent Families:
    Through our fundraising efforts, Extreme Outreach endeavors to cover the camp fees of children from 'low income' single parent families who are 'not' on social assistance, as well as those who have been denied by social services their child's camp fee. If you are able to help by paying any amount towards your child's fee, we would appreciate it. If you select "yes" below when asked if you need financial assistance, you will be contacted by the EOS Office to discuss your situation. Documentation will be required.

    We welcome camp registration applications for children from all economic circumstances. If the notes above do not apply to you, then we require payment of the camp fee of $200 in full. Our SuperKids camp is the most inexpensive camp around as many other week-long overnight camps cost from $300-$500. We have kept the fee low in order to make it possible for every child to have the opportunity to come to camp!

    PAYMENT: After submitting this form you will be contacted by the EOS Office within 1 to 2 weeks to arrange payment.

    Do you need financial assistance (based on the notes above)?

    Are you currently on Government Social Assistance?

    APPLICANT'S STATEMENT

    PLEASE READ CAREFULLY AND SIGN BELOW TO INDICATE YOUR ACCEPTANCE

    MEDICAL RELEASE:
    I authorize the administration of any first aid treatment necessary at SuperKids
    Camp for my child. In the case of a medical emergency I authorize my child
    to be transported by designated leaders or arrange for transportation to
    the nearest medical or hospital facility. In such an emergency I hereby give
    permission to the physician involved to secure proper treatment for my child.
    In the event extraordinary transportation or medical treatment is required, I
    agree that Extreme Outreach cannot accept the financial responsibility.
    I expect to be contacted as soon as possible.

    LIABILITY WAIVER:
    I understand that Extreme Outreach is a Christian organization and that my
    child will be receiving Bible teaching at Super Kids Camp. Extreme Outreach
    reserves the right to dismiss a child who in their opinion is a hazard to the
    safety and the rights of others, or who appears to have rejected the camp rules
    as directed by the designated camp leaders. A child who must be sent home
    due to disciplinary action or home sickness must be picked up by a parent(s)
    or designated emergency contact. No refund will be given for a dismissal due
    to disciplinary action, home sickness, late arrival or early departure. I am
    confident that Extreme Outreach staff will do their best to give my child the
    necessary support and supervision needed and I understand that the safety
    and health rules will be observed. To the best of my knowledge, my child is
    in good health and physically, emotional, and socially able to participate in all
    camp activities. I give my child permission to participate in all camp activities.
    If my child is not physically, emotionally or socially able to participate in all
    camp activities, I understand that Extreme Outreach does not have the people
    for one on one with my child and they may be unable to attend camp. I give
    Camp staff permission to transport my child to and from Victoria to Camp
    Barnard, located in Sooke, BC. I hereby release Extreme Outreach Society and
    its personnel from all claims and damages arising from any accidents or injury
    caused by my child’s participation in the camp program or by transportation
    to and from camp. Extreme Outreach is not responsible for lost, stolen, or
    damaged items during my child’s participation at camp. I agree that photos or
    video of my child taken at SuperKids may be used in future Extreme Outreach
    and/or SuperKids promotional material. If I am not in agreement with this, I
    will give a written notice to Extreme Outreach that the photos and videos are
    not be used for this purpose. The parent/guardian submitting this application are
    those having legal custody over the child. Conditions of custody, if applicable,
    will be fully communicated in writing to the camp including a photocopy of the
    section of any court order referring to the visitation rights.