External Camp Application

Section 1: Your Child

Child's Name

First Name

Last Name

Usual Name (if different)

Birthdate

Gender/Pronoun

Language spoken at home

Section 2: Every Parent/Guardian of this Child

Parent/Guardian Name

First Name

Last Name/Surname

Mobile Phone

Home Phone

Business Phone

Ext.

Residential Address

Street Address

Apt./Unit or "N/A"

City/Town

Province/State

Postal Code/Zip Code

Country

Add another Parent/Guardian Remove

Section 2: Your Child's Health

Allergies

Overall state of health

Describe any current health concerns other than allergies

List your child’s current medications, if any

Section 3: Application Questions

For the following section, please provide detailed responses.

Child's current school

Describe your child’s interests and extracurricular activities.

If your child has any special needs (educational, emotional, social, etc.) please provide details.

Summarize your child’s experience with group recreational programming.

School's Discretionary Authority re: External Camp Applicants

HIS camps are typically offered only to HIS students. External applicants are invited to apply at our discretion, based on an existing connection and arrangement with the Headteacher. As stated in the online application form, the acceptance and ongoing participation of all external camp applicants happens at the sole discretion of the Headteacher or their designate. Participation in the camp can be terminated immediately, with or without refund, in the event of behavioural challenges on the part of the camper or the family.

Acknowledgement of Terms of Acceptance/Participation

I acknowledge that my child's acceptance and ongoing participation in HIS camps happens at the sole discretion of the Headteacher or their designate, subject to the terms detailed above.

Additional Details

Please provide a scan of your child's birth certificate here, or by email to office@halifaxindependentschool.ns.ca.

Copy of Birth Certificate

Maximum file size: 10MB

(May be supplied in a follow-up email if preferred)

Emergency Contact in addition to the child's parent(s)

Emergency Contact Name

First

Last

Relationship to Child

Mobile Phone

Home Phone

Business Phone

Ext.

If you are human, leave this field blank.