SA Week 1

Blackstrap Youth Camp

Time For Growing

Week 1 Sponsorship Application

Name*
First Last
Address*
Street Address City State / Province / Region ZIP / Postal Code Country
Gender*
BIrthday*

DD
MM
YYYY

Camper must be between ages 8 - 14
School*

Saskatchewan Hospitalization Number*
MSI/Blue Cross Number
Family Doctor*
Family Doctor Phone*
Medications
Please list all medicines and prescription medications that will be brought to camp. Upon arrival at camp, all medicines and prescription medications must be given to the camp nurse for safe keeping. It must be clearly labelled stating drug name, directions for use, and the camper's name.

Additional Information
Dietary Needs/Allergies/Asthma/Sleep problems/Dorm Assignment Requests/Etc.

Injury Waiver*
I agree to the injury waiver
Experience has shown that with camping activities, there are times when illness or accidents may occur and medical attention becomes necessary. This is my permission for the official in charge to make arrangements for medical attention for my child/ward in the event of an emergency, without necessity of my prior approval. I understand I will be notified by the quickest means possible if this authority is exercised. I waive all claims against the Knights of Columbus Blackstrap Youth Camp (Saskatoon Youth Development Complex Inc.) and its employees and representatives for any accident or injury to the camper or to his or her property in connection with this camp.
Social Media Waiver*
I agree to the social media waiver.
I hereby grant permission to Blackstrap Youth Camp (Saskatoon Youth Development Complex) to use photographs and/or video of my child participating in camp activities for promotional and advertising purposes in presentations or on social media and the camp website.

Please provide information for an endorser that can verify the financial need for assistance and subsidy for this camper to attend BYC. Endorsers will be contacted as part of the sponsorship application selection process. Endorsers MUST be in one of the positions listed below.
Endorser Name*
First Last
Endorser Phone*
Endorser Email*
Endorser Organization*
Endorser Position*
- Knight of Columbus
- Clergy Member
- School Principal
- School Co-ordinator
- Social Worker