Thank You – Summer Adventures

WAIVER AND CONDITIONS OF ENROLMENT

1. The parent/guardian(s) of the above-named participant, release the Empower Simcoe Youth Program, its Youth Facilitator, Supervisor, Staff and Volunteers from any loss, personal injury, accident, misfortune or damage to the above-named or his/her property, with the understanding that reasonable precautions shall be taken to ensure the health and safety of the above-named participant.
2. If the above-named participant requires medication to be administered at any time during Youth Program (Youth Link after school, March Break, and Summer programs), the parent/guardian agrees to provide Empower Simcoe with clearly labeled medication in blister packaging with instructions for administration as stated on Empower Simcoe’s medication direction form. You will be contacted by a Youth Facilitator to complete this paperwork.  All Medications Must Come Blister Packaged- please arrange for the youth’s medication to be blister packaged with your pharmacist and only bring what is required for the duration of the camp. Blister Packaging: arranged at the pharmacy where each dose of medication is separated by morning/afternoon/night and sealed.  Please be advised that we ask this to ensure the safety of all youth and support staff involved at the camp, this policy helps reduce the risk of any medication error.
3. In case of medical emergency, the parent/guardian(s) of the above-named participant understands that every effort will be made to contact them. In the event that the parent/guardian cannot be reached, I/we give permission to the Empower Simcoe Staff and the attending doctor to secure medical treatment for and/or hospitalize the above-named participant.
4. Empower Simcoe reserves the right to dismiss or not accept a participant who, in our opinion presents a hazard to the safety and rights of others, or who appears to have rejected the reasonable controls of the program. Failure to disclose any medical, emotional or behavioural conditions on this form could results in the youth being excused from Empower Simcoe programming without refund.
5. If it is determined that a participant requires a 1:1 support worker, the parent/guardian is responsible for arranging this support, a youth may not be invited back to our program until a suitable support is in place. All 1:1 workers must provide a Criminal Reference Check with Vulnerable Sector Screening completed within 90 days, and/or an attestation from their agency outlining the screening they have undertaken for employment, as well as a declaration stating their CRC remains clear.

REFUND POLICY: In order to receive a refund for a Youth Program purchase, sufficient notice must be given prior to the date of the program time:

• Summer Adventures weekly programming: cancellation is required two weeks or more prior to the start of the program – full refund issued less a $50.00 administration fee. Withdrawal during the week’s program on physician’s order – one half of fee for unexpired term will be refunded. No refund will be made for dismissals due to disciplinary action, late arrivals or early departures.
• Youth Link programming: cancellation provided with more than 48 hours notice; a credit will be applied to the youth’s account to attend an upcoming Youth Link program when possible.
• Multiple week programs (example Circles, Taste Makers, etc): cancellation is required one week or more prior to the start of the program – full refund issued less a $25.00 administration fee. Withdrawal after the program sessions have started on physician’s order – one half of fee for unexpired term will be refunded. No refund will be made for dismissals due to disciplinary action, late arrivals, or early departures.

I have read and hereby agree with the waivers and conditions of enrolment.