2012 Camp Application

Please complete the online application form below to apply for Horizon Arts Camp's 2012 summer season. Please note: you will be required to submit a $25 application fee upon completion of this form.

This form should be completed for campers, LITs and CITs. Applying does not guarantee enrollment. Those applying for the Counsellor-In-Training Program will be required to submit an additional CIT Application Form.

Please ensure you familiarize yourself with the 2012 Fee Schedule & Session Dates before completing this application form.

Please note this online form is secure, but is not encrypted during transmission. Hard copy versions are available for download should that be your preference.

* are required fields!


CAMP APPLICATION SESSION REQUEST
∗The session you are enrolling your child in is:
Session 1: July 2-20 (3-weeks) Session 2: July 30-August 17 (3-weeks) Session A: July 2-6 (1-week) Session B: July 9-13 (1-week) Session C: July 30-August 3 (1-week) Session D: August 6-10 (1-week) LIT/CIT Program: July 2-August 17 (7-weeks)
∗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 11/12 school year:
∗Birthdate: (DD/MM/YY)
∗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:
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:
FAMILY STATUS
∗The camper is living at home with:
∗Are parents separated or divorced?
Yes No
If parents are separated or divorced, or if the child is not living with parents, 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. H.A.C. uses this information to ensure that your child has the appropriate supports at camp to be successful.
∗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, illness, employment changes)?
Yes No
If YES, please explain:

ARTISTIC RECOMMENDATION INFORMATION - 3 Week Sessions Only All new campers applying to sessions 1 or 2 are required to submit an Artistic Recommendation Form from a school arts teacher, private arts instructor, etc. Please provide your referee's contact information so it can be matched with the form.
Referee's First & Last Name:
Position or Title:
Name of School or Organization:
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?	Yes No
If yes, please explain:

∗Does your child play an instrument?
Yes No
If yes, what instrument?
ARTS MAJORS - UPPER CAMPERS (3-Week Sessions) & LIT's ONLY If your child will be in Upper Camp (currently in grades 6-8) or in the Leader-In-Training (LIT) Program (currently in grade 9) 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.
Session One (July 2-20, 2012) Major Choices. Please select if you are applying for this session
Music - Music from the Movies
Dance
Theatre - Sketch Comedy: SNL Style
Visual Arts - Clay Sculpture: Creating in the Third Dimension
Session Two (July 30-August 17, 2012) Major Choices. Please select if you are applying for this session.
Music - A Broadway SMASH!
Dance
Theatre - Acting for Film & TV: The Golden Globes
Visual Arts - Illustration, Imagination and Story Creation
ADDITIONAL INFORMATION
Please list the languages spoken at home:
Parent/Guardian Country of Origin is:
Child's Country of Origin is:
∗How did you hear about Horizon Arts Camp? If a specific person referred you, please enter their full name here:
CAMP FEES Please indicate whether you would like to be contacted regarding a payment plan option for your camp fees.
Yes No
∗Please indicate whether you will be submitting a Scholarship Application Package.
Yes No
BUS TRANSPORTATION & EXTENDED CARE PROGRAMS
Please note that campers cannot enroll in both the Breakfast Club/After Camp Care 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 After Camp Care: 4:00pm - 5:30pm Bus Transportation to and from camp Not required
If you would like to make use of the Camp's daily bus transportation program, one of the Directors will contact you regarding bus stop locations.
If you received a PROMO CODE or GIFT CERTIFICATE please enter it here (please note that that only one will be accepted per application):
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 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 my child's referee can provide information to complete the artistic recommendation form and that the camp can contact the referee to obtain further information if required. 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)