BugQuest Senior 2017

Appropriate for children aged 8 - 12, born in 2005 - 2009.

Camp hours: 9:00am to 4:00pm

Before care (8:00am to 9:00am) and after care (4:00pm to 5:00pm) are available at a cost of $20.00 each for the week.


Camper Information


Session(*)
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First Name(*)
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Last Name(*)
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Address(*)
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Gender(*)
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Date of Birth(*)
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Allergies or dietary restrictions?(*)
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Health Card Number (Optional)
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Each camper receives a free t-shirt on the first day of camp!

Click here for t-shirt sizing guidelines.

Size(*)
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Parent/Guardian Information


Parent/Guardian #1(*)
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Phone Number(*)
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Alternate Phone
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E-mail Address(*)
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Parent/Guardian #2
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Phone Number
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Alternate Phone
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E-mail Address
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Emergency Contact Information

(If parents are not available)


Emergency Contact #1(*)
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Phone Number(*)
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Alternate Phone
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Relationship to Camper(*)
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Emergency Contact #2
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Phone Number
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Alternate Phone
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Relationship to Camper
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Authorized Pick-Up


Please indicate below the name of any other person authorized to pick-up your camper that is not listed above as a parent/guardian/emergency contact. All persons listed will be asked to show personal identification.


Name(s)
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Camp Ready


To support the success, safety, and inclusion of all individuals participating in BugQuest Day Camps, it is important that all campers are "camp ready" (please see Camp Policies for Camp Ready Checklist). Some participants may require additional support to assist them in being successful at camp. Cambridge Butterfly Conservatory is unable to provide one-on-one support. Please describe your child's behaviour in terms of activity level, attention span, impulsiveness, etc. and indicate any strategies/techniques that you find useful in managing your child's behaviour that would assist our camp staff in providing a positive camp experience for your camper. Our goal is your camper's safety and success!


Comments(*)
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Photo Release


I am aware that photographs, motion picture or video tapes may be made of my camper by Cambridge Butterfly Conservatory to appear on the Cambridge Butterfly Conservatory Website or in other print and/or publication materials


Photo Release (Optional)
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Informed Consent & Medical Consent Agreement


I, the parent/guardian of the registering camper, consent to his/her participation in the Cambridge Butterfly Conservatory BugQuest Summer 2015 Program and related activities, which are designed to encourage entomological and scientific interest and will involve hands-on activities and laboratory exercises. I also agree to release and forever indemnify Cambridge Butterfly Conservatory from any and all claims for damages arising as a result of injury or otherwise sustained by the herein named camper arising from participation in any and all camp activities.


I understand that BugQuest has a Camp Ready policy to ensure the safety of all participants. I have read an understand the Camp Ready policy and believe my camper to be "Camp Ready". I have read and understand the BugQuest policies and behaviuor expectations.


Cambridge Butterfly Conservatory reserves the right to terminate the registration of any camper, if, in the opinion of the Executive Director, it is in the best interest of the camper or camp. If Cambridge Butterfly Conservatory terminates a camper's registration, a proportional refund will be considered.


I understand that nuts or nut products are not allowed at BugQuest and I acknowledge that Cambridge Butterfly Conservatory cannot guarantee a nut-free environment. I have provided Cambridge Butterfly Conservatory with all of the necessary medical information and can be reached at the number(s) provided. I allow the above mentioned camper to receive basic first aid - medical care from instructors certified in first aid or from trained professionals if necessary. I agree to be responsible for any emergency medical expense incurred. I also certify that the information provided about my camper is correct. I consent to and assume all risks and hazards of and incidental to the participation of the above-mentioned camper in the activities of BugQuest.


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Enter the 4 digit code(*)
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