Winter Camp 2025 - Sidrabene

Ziemas Nometne/Winter Camp 2025!

no 31. janvāra līdz 2. februārim

Friday:
CIT drop-off @ 5:30pm

Camper drop-off @ 6pm

Sunday:

CIT & camper pick-up @ 6pm

Registration is OPEN!

*Once registration has closed, emails regarding a packing list, possible themes, reminders on drop-off procedures etc. will be sent out.*

*Feel free to email us if you have any questions - sidrabenesnometne@gmail.com*

Ziemas Nometne/Winter Camp 2025 Registration Form

"*" indicates required fields

Step 1 of 2

50%

Name of the Parent/Guardian Completing This Form*

All camp communications will be sent to the email address provided. Please complete one registration form per camper.

First Last

Email Address*

Camper's Information

Child's Name*

First Last

Date of Birth*

mm / dd / yyyy

Age at Camp*

Sex*

Latvian Comprehension*

First Parent / Guardian Information

Please enter name of first parent/guardian*

First Last

Relationship to camper*

Phone #*

E-pasts*

Address*

Street Address City Province Postal Code

Second Parent / Guardian Information

Please enter name of second parent/guardian

First Last

Relationship to camper

Phone #

E-pasts

Address

Address*

Street Address City Province Postal Code

Church Affiliation*

Join us for Church service on Sunday morning at 11am.

Are there any other people, in addition to the parents/guardians above, who are authorized to pick-up/sign-out the camper?*

Yes

Please enter their full names*

Consent*

I give my child/children permission to participate in day trips and supervised activities outside Camp Sidrabene boundaries during his/her/their attendance at Camp Sidrabene. I consent to my child/children being driven to/from these activities by an adult member of Camp Sidrabene, operating under the umbrella of St. Andrew’s Ev. Luth. Latvian Congregation in Toronto.

I understand that the St. Andrew’s Ev. Luth. Latvian Congregation, Camp Ministry, will do its best to follow the guidelines set out in ‘Policy to Protect Children,Youth and Other Vulnerable People in the ELCIC’, which is intended for the health, safety and protection of the children, youth, other vulnerable people and the volunteers/staff of St. Andrew’s Ev. Luth. Latvian Congregation.

I have read and agree to these terms and conditions.

Photo Consent*

Images of my child/children, captured during regular and special camp activities through video, photo and digital camera, may be used solely for the purposes of Camp Sidrabene promotional material and publications without any rights of compensation or ownership thereto. I agree to have images of my child/children displayed on Facebook, Instagram, the Camp Sidrabene/St. Andrews Church website, Latvija Amerika Newspaper, Zils un Balts (camp yearbook) including individual child images and group images.

I have read and agree to these terms and conditions.

I do not consent

Winter Weather*

I am aware that the following types of accommodations will be utilized: winterized and non-winterized buildings. I acknowledge that I will read the packing list provided by Camp Sidrabene.
I acknowledge that I will undertake to provide all the necessary clothing and equipment for my child. I accept full responsibility for inadequate clothing or equipment and for clothing and equipment which I fail to provide my child.

I have read and understand these terms and conditions.

Physical Fitness/Health Certificate

OHIP Number (incl. version code)*

Physician's Name*

Physician's Phone #*

Emergency Medical Contact Information*

First Last

Phone #*

Relationship to camper*

Chicken pox immunization*

MM slash DD slash YYYY

Meningitis immunization*

MM slash DD slash YYYY

Diphtheria/Pertussis/Tetanus/Polio immunization*

MM slash DD slash YYYY

MMR (Measles/Mumps/Rubella) immunization*

MM slash DD slash YYYY

Hepatitis B immunization

MM slash DD slash YYYY

Date of most recent physical examination*

MM slash DD slash YYYY

Does the camper have any allergies?*

Yes

Please explain.*

If your child has a serious or potentially life-threatening allergy (bee stings, peanuts, etc.) he/she must come to camp with his/her own personal EPIPEN (or equivalent injectable adrenalin) and camp staff be so notified. Medications are to be turned in to camp administration/camp nurse.

Does the camper have asthma?*

Yes

If yes, please indicate severity.*

Mild

Moderate

Severe

Made worse by activity

What triggers these attacks? Please explain.*

Will the camper be taking any medications while at camp? (Prescription and/or over-the-counter)*

Medications are to be turned into camp administration/camp nurse.

Yes

If yes, please explain.*

Will the camper require any treatments while at camp?*

Yes

If yes, please explain.*

May the following over-the-counter medications be given to your child while at camp, if deemed necessary by the nurse?*

Please check all that may be administered to your child.

Acetaminophen (Tylenol)

Ibuprofen (Advil)

Cough/cold syrup

Antihistamines (e.g. Benadryl)

Anti-nausea liquid (e.g. Gravol)

Antacids (e.g. Tums)

None

Has your child experienced or is currently experiencing any of the following conditions:*

ADD/ADHD

Athlete's foot

Back/Neck Pain or Injury

Bedwetting

Behavioural Issues

Blackouts/Fainting

Bleeding Disorders

Chest Pain

Crohns/Colitis/IBS

Concussion

Constipation/Diarrhea

Dental Braces/Caps/Bridges

Developmental Delays

Diabetes

Ear Infections/Hearing Problems

Epilepsy/Seizures

Fetal Alcohol Syndrome

Headaches/Migraines

Homesickness

Kidney Disease

Learning Disabilities

Menstrual Difficulties

Mental Health Issues/Depression/Anxiety

Motion Sickness

Nightmares/Terrors

Nosebleeds

Sinus Infections

Skin Problems

Sleepwalking

Speech Problems

Stomach Aches

Sprains, Strains, Fractures

Tonsillitis

Urinary Tract Infection

Visual Problems/Wears Glasses/Contacts

Weight Concerns/Eating Disorder

Other

Not Applicable

Please be sure to fully explain any conditions your child is currently experiencing. It is important to include ALL information regarding the camper's history of illness so that our staff are prepared in case of incident or emergency.*

Does the camper have any dietary restrictions?*

Vegetarian

Vegan

Lactose Intolerant

Gluten Free

Other

Not Applicable

Please explain.*

Does the camper have any restrictions on activity?*

Camp Sidrabene is located on a rugged, wooded site. Most of the activities take place outdoors.

Yes

If yes, please explain.*

If female, has camper menstruated?*

Yes

Not Applicable

Has she had menstruation explained to her?*

Yes

Not Applicable

Please list any other medical information the camp should know about your child.

Health Consent*

I understand that all information collected will be used to diagnose, treat or maintain my child's physical and/or mental health and to assist in preventing disease or injury or to promote health. This information is considered to be confidential and will be shared amongst health care providers as needed; ie Camp Nurse, Camp Physician, Walk-In Clinic or Emergency Health Care Providers. This information will only be shared to Camp Director and Camp Staff on a need to know basis to ensure the physical and mental health of my child.

To the best of my knowledge, my child is in good health and has not been exposed to any infectious disease in the past 3 weeks and has not been ill and is physically able to participate in all camp activities, except as previously indicated. I will notify camp in writing prior to arrival if there is any change to my child's health or he/she is exposed to any communicable disease within 3 weeks prior to arrival at camp.

I hereby give permission to Camp Sidrabene to secure emergency medical and surgical treatment and to provide routine, non-surgical medical care for the child named above while attending Camp Sidrabene. It is understood that medical care will be secured promptly and that parents/guardians will be notified at the earliest possible opportunity.

I will submit any changes to this health form in writing to the camp prior to arrival.

In the event of accident, sickness or other medical emergency, St. Andrew’s Ev. Luth. Church, its pastor, staff and volunteers are hereby released from any liability.

I have read and agree to these terms and conditions.

Head Lice Check*

I will do a head lice check on my child regularly and within 3 days before arriving at camp. If my child's head is NOT deemed nit/lice free I will not bring them to camp. Campers found to have head lice on arrival will not be allowed to enter camp until the matter has been resolved.

I have read and agree to these terms and conditions

Price per Child

**Your child will remain in the same position as he/she was in Summer 2024 (e.g. campers who are now of age to be CITs will remain as campers)**

Price:

Signature of Parent/Guardian*

Please type your full name here to acknowledge consent.

Credit Card

Cardholder Name

Card Details

Name

This field is for validation purposes and should be left unchanged.

Ziemas Nometne/Winter Camp 2025!

no 31. janvāra līdz 2. februārim

Registration is OPEN!

Ziemas Nometne/Winter Camp 2025 Registration Form

Camper's Information

First Parent / Guardian Information

Second Parent / Guardian Information

Physical Fitness/Health Certificate

Veiciet Ziedojumu

Sidrabenes Latviešu Atpūtas un Rekolekciju Centrs

Sidrabene's Latvian Summer Camp

Sv. Andreja Evaņģeliski Luteriskā Latviešu Draudze Toronto