Registration | Golden Lake Camp

"*" indicates required fields

Camper Information

Our Jr 1 camp (July 9-15) is now filled. There are still spaces in Jr 2 and Intermediate.

The person completing this form is*

Parent/Guardian

Sponsoring Agency

Camper's Name*

First Last

Birthdate*

Age as of July 1st of this year*

Please enter a number from 6 to 18.

Gender*

Address*

Street Address Address Line 2 City Province Postal Code

Attended GLC Before?*

Yes

Religious Affiliation*

United Church

Anglican Church

Roman Catholic

None

Other

Parent(s)/Guardian(s) Name(s)*

First Last

Parent(s) Email*

Must be an email you check regularly. Important confirmations and updates will be sent to this address.

Parent(s) Phone - Primary Number*

Parent(s) Phone - Alternate Number*

Emergency Contact*

In case the Parent/Guardian is not available

NOTE: This cannot be the same as the Parent/Guardian completing this form

First Last

Emergency Contact Phone*

Choice of Camp and Rates

Choices of Weeks and Dates*

Our Jr 1 camp (July 9-15) is now filled. There are still spaces in Jr 2 and Intermediate.

Junior 1 July 9 - 15

Junior 2 July 16 - 22

Intermediate 1 July 23 - 29

Rate you will pay*

$465 (1st camper - one week)

$395 (Additional camper, or an additional week for 1st camper)

Requesting Geared-to-income or Other Arrangement

If this is an additional camper, who is the previous camper?

Agency Rate Product

Price:

Rate

Price: $ 0.00 CAD

Geared-to-Income or Other Arrangement

Golden Lake Camp guarantees that every child who wishes to come to camp will be financially able to do so.

Sometimes this involves making special financial arrangements, including arranging subsidies from willing and supportive churches or organizations, or offering special rates or payment plans based on parents’ abilities to pay.

If our registrar (or some other qualified person) has already spoken to you about some special arrangement, please choose “Making a special arrangement” from the choices in the following section, and then briefly describe that arrangement in the box below. Your child will then be registered for camp.

To request a “Geared-to-Income” rate for your child, please choose the appropriate description from the choices in the following section; then briefly describe your particular situation in the box below, and indicate how we should contact you. Questions? Contact us at 1-888-659-2267 or goldenlakecamp@gmail.com).

Hidden

Geared to Income

Our "Geared-to-Income" and "Extended-Payment" Plans guarantee that no child who wishes to attend Golden Lake Camp is ever turned down for financial reasons. Simply complete the section below and send in the form. Our registrar will then register your child for camp, and contact you by phone or email, to work out with you a rate you can afford, or design an "Extended-Payment plan that will work for you. If you have questions, call us at 1-888-659-2267, or email us at goldenlakecamp@gmail.com.

Which of the following best describes your family's situation?*

Please briefly explain your situation*

PLEASE NOTE: When we contact you, all information we receive is confidential.

Like to donate to our Camper Subsidy Fund?*

Our Camper Subsidy Fund is used to help children who would otherwise be unable to attend camp for financial reasons. A tax receipt is available for all such donations.

Yes, I would like to donate

Sorry, not this year

Donation Amount

$10 Donation

$25 Donation

$50 Donation

$75 Donation

$100 Donation

Need a donation receipt for tax purposes?*

Yes

Other Helpful Information

Does this camper have any serious allergies / medical conditions / mental health issues / behavioural issues (A detailed health form will be sent to you later)*

Details you would like us to know

Also inviting a friend?*

Yes

Like to be in the same cabin as a friend? (Indicate below- *ONE* name only, please.)

What is your child’s T-shirt size?*

(Every camper will receive a free T- shirt)

Youth Medium

Youth Large

Adult Small

Adult Medium

Adult Large

Adult Extra-Large

Other

How many different ways did you hear about Golden Lake camp? Please check all that apply*

Other

Paying for your child's attendance

NOTE: send no money until we confirm a space for your child, because camps are filling up.

How do you plan to pay*

Note: You will be directed to PayPal to submit the payment using your credit card
(a PayPal account is not needed)

Note: You have selected Payment by "Other Arrangement". We will contact you to finalize details.

Note: Send your e-transfer to registergoldenlake@gmail.com.
Please include the camper's name and week of the camp

Note: Cheque should be payable to Golden Lake Camp.

Please note on the cheque the name(s) ofthe child/children you are paying for, and the weeks they will be attending.
Mail to: Golden Lake Camp c/o 979 Slate Falls Rd., Denbigh, ON K0K 1L0. Then send an email to registergoldenlake@gmail.com to say the cheque has been sent.

Deposit ($50)*

Price:

Requesting a receipt for tax purposes?*

Yes

Sponsoring Agency Information

Name of Agency to be Billed*

Agency Contact Name*

Agency Billing Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Agency Contact Email*

Agency Contact Phone*

Prove you're a human...

Please enter the text you see below into the box, to prove you're a human.

Total

Note: A $50 Deposit will be the payment requested at this time.