2010 Camp Application

Please complete the online application form below to apply for Horizon Arts Camp's 2010 summer season.

This form should be completed for campers, LITs and CITs. Those applying for the Leadership Programs will be required to answer additional questions. Once your application has been received the camp will email you some narrative questions to answer.

Please ensure you familiarize yourself with the 2010 Fee Schedule before completing this application form.

* are required fields!


SESSION REQUEST
∗The session you are enrolling your child in is:
July 5 - July 23, 2010 August 2 - 20, 2010 LIT/CIT Program: July 5 - August 20, 2010
∗Please check what program you are registering your child in. Please ensure your child is the appropriate age for each program.
Camper Leader-In-Training (LIT) Counsellor-In-Training (CIT)
CAMPER/LIT/CIT INFORMATION
∗Child's First Name:
∗Child's Last Name:
∗Gender:
∗Age:
∗Grade Completing in 09/10 school year:
∗Birthdate:
∗Address:
Suite/Apt.#:
∗City:
∗Province:
∗Postal Code:
∗Home Phone Number:
∗Name of school child attends:
FAMILY INFORMATION
Guardian/Parent #1
∗Relationship to Child:
∗First Name:
∗Last Name:
Address (if different from camper):
Suite/Apt.#:
City:
Province:
Postal Code:
∗Home Phone:
Work Phone:
Cell Phone:
∗Email Address:
∗Occupation:
Guardian/Parent #2
Relationship to Child:
First Name:
Last Name:
Address (if different from camper):
Suite/Apt.#:
City:
Province:
Postal Code:
Home Phone:
Work Phone:
Cell Phone:
Email Address:
Occupation:
FAMILY STATUS
∗The camper is living at home with:
∗Are parents separated or divorced?
Yes No
If parents are separated or divorced, who has legal custody of the child?

HEALTH/BEHAVIOURAL INFORMATION Please answer the following questions regarding your child. A full health form will be sent to all applicants that are accepted.
∗Does your child have any life threatening allergies?
Yes No
If YES please explain:

∗Does your child have any of the following (please check all that apply):
ADD/ADHD Learning Disabilities Autism Spectrum Disorder Physical Challenges (vision impairment, chronic injuries, etc.) Epilepsy Diabetes Mental Health Concerns History of Abuse/Domestic Violence Other None of the above
∗Are there any behavioural concerns at school or at home?
Yes No
If YES, please explain:

∗Is your child experiencing stressful or difficult life situations (i.e. separation, divorce, death, violence, illness, employment changes)?
Yes No
If YES, please explain:

RECOMMENDATION INFORMATION All campers are required to submit a Recommendation Form from a school, private arts instructor, community agency or social worker in order to complete your child's application. Please provide their contact information so it can match with the form.
∗Name of Referring Organization:
∗Contact Person:
∗Title:
∗Phone Number:
∗Email Address:
ARTISTIC EXPERIENCE Please answer the following about your child's experiences in the arts
∗Has your child taken lessons in the performing (music, dance, or theatre) or visual arts outside of school?	Yes No
If yes, please explain:

∗Does your child play an instrument?
Yes No
If yes, what instrument?
ARTS MAJORS - UPPER CAMPERS & LIT's ONLY If your child will be in Upper Camp (they have turned 11 - 13 years of age as of December 31 2009) or in the Leader-In-Training (LIT) Program (turned 14 years of age as of December 31 2009) please fill out the following section. A major is a specific arts discipline that a camper would like to concentrate on during each 3-week session. My child is interested in the following arts major (please note that you may only choose one major per session and the camp cannot guarantee that the camper will receive their first choice.) The Camp also considers previous experience when assigning major placements.
First Session (July 5 - 23, 2010) Major Choices. Please select if you are applying for this session
Music: Top Of The Billboard Charts
Dance: Dancing Through The Decades
Theatre: A Journey Through Myth & Mask
Visual Arts: Claymation Creation
Second Session (August 2-20, 2010) Major Choices Please select if you are applying for this session.
Music: Glee Club
Dance: Contemporary Hip Hop Fusion
Theatre: Shakespeare Goes To The Movies
Visual Arts: Hot Off The Printmaking Press!
ADDITIONAL INFORMATION
∗Please list the languages spoken at home:
∗Parent/Guardian Country of Origin is:
∗Child's Country of Origin is:
∗T-shirt Size: (Each Camper will receive a camp t-shirt. Please select the appropriate size)
∗How many people are living in the household?
CAMP FEES Camp fees are based on a sliding scale according to the total household income and the number of people living in the home. Please visit the Fees & Assistance section of our website for the 2010 fee schedule. Please note that proof of income is required for all income earners in the family in the form of a pay stub, tax summary or assessment form. If you require further subsidy to be able to afford the camp fees please complete the Subsidy Section below.
∗Total household income (before taxes):
less than $20,000 $20,001-$28,000 $28,001-$36,000 $36,001-$44,000 $44,001-$52,000 $52,001-$60,000 $60,001-$68,000 $68,001 - $100,000 over $100,000
BREAKFAST CLUB & BUS TRANSPORTATION
Please note that campers cannot enroll in both the Breakfast Club and Bus Transportation as program times overlap. If required, please select which program you would like your child to be enrolled in.
Breakfast Club 8:00am-8:30am, Cost: $20 Bus Transportation to and from camp, Cost: $35 Not required
If you would like to make use of the Camp's daily bus transportation program please select the bus stop location that you would like to use each day. Bussing service is not available for occasional use. Registration is required for the entire session.

SUBSIDY INFORMATION Camp fees may be further subsidized in cases of increased financial need. Should you require a subsidy to afford the camp fees please take the time to answer the following questions regarding your financial situation. Please note that the Camp may be unable to provide further subsidy to all families that apply. If you do not require a subsidy please scroll down to the next section.
Number of adults living in the household?

Number of children living in the household under the age of 18?

Sources of income (check all that apply):
Employment Ontario Works/Social Assistance ODSP E.I. Other
Is the family (please select):
Single Parent Dual Parent Single Income Dual Income
Is the family living in a Toronto Community House building or other subsidized housing?
Yes No
Please use the space below to inform the Camp of any extenuating circumstances that you would like to share related to your need for further subsidy?

Would you like the camp to contact you to discuss the camp fees?
Yes please No thank you
IN SUBMITTING THIS APPLICATION, I AGREE TO THE FOLLOWING: that my child can participate in all camp activities and supervised trips not on camp property. to provide the camp with proof of household income in the form of a T4 slip, pay stub or tax assessment. to provide the camp with a completed health form, authorized pick-up form and payment if my child is accepted. that my child is authorized to eat/drink all meals or snacks provided by the camp, unless otherwise notified by me. that the camp reserves the right to photograph and/or videotape all camp programs and use the images for promotional purposes, unless notified by the parent/guardian in writing on or before the first day of camp. that I understand that I will not receive a refund for any days my child is absent from camp. that the camp reserves the right to terminate the registration of any camper if, in the camp's discretion, it is determined that such termination is to be in the best interest of the camper or the camp. that the information in the camper application is true and correct. that I am the legal guardian/parent for the camper applying to Horizon Arts Camp and I am authorized to submit this application form for this child.
∗I have read, understand and accept the terms and conditions above:
Yes No (your application will not be reviewed)

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