1. Do it For Life!! Summer Camp To Promote Physical Activity and Healthy Living Sponsored by SchoolsPlus and CBRM Recreation Department Grades: 1-5 (Ages 5-11) Date: July 29 th – August 2nd Location: 500 Terrace St. (SPEC) Time: 9am - 2:00pm Cost: FREE!!! Come enjoy an awesome line up of fun physical activities and fantastic healthy foods. Explore and learn about different activities, sports and healthy eating with your peers!! To register your child, please call Lindsay Latham at 563-4551 - Children are to dress appropriate for physical activities. - Lunch, Snacks and drinks will be provided daily. -Camp is limited to 50 students. First Come First Served! -To register, please call and reserve a spot! Registration form must be received on or before the first day of camp for your child to attend. CBRM Recreation

2. REGISTRATION/PERMISSION FORM Child’s Name: _______________________Gender: M/F Grade: ______ Parent Name: ____________________ Daytime phone#: _____________ Cell #:___________________ Emergency Contact : ____________________ Phone #:______________ Health Card #: ________________________ Medical Conditions/Allergies: _________________________________________________________________ _________________________________________________________________ By signing below, parents release the SchoolsPlus program and the CBRM Recreation Department from liability due to injuries, etc that may occur as a result of my child's attendance and/or participation in the “Do it For Life” Summer Camp. I am giving permission to the instructors to make arrangement for medical attention for my child in the event of an emergency. I understand that I will be notified as soon as possible if this authority is exercised. Name of Parent:_______________________________________ Signature of Parent: _______________________ Date: ____________ Do it For Life!! Summer Camp To Promote Physical Activity and Healthy Living Sponsored by SchoolsPlus and CBRM Recreation Department CBRM Recreation

3. PERMISSION RELEASE FORM FOR STUDENT WORK AND IMAGIES SchoolsPlus...is proud of its students and their work and we take many opportunities to publicize student accomplishments. Artwork/Written Work/Digital Work for Display: Throughout the school year your child will be producing a variety of creative assignments (art work, stories, poetry, digital project, etc.). On occasion, the need may arise to display or publish these assignments in the classroom or in various school and board locations and publications including Department of Education, board and school websites. Photographs/Media Interviews: The school may, from time to time, be contracted by the media (newspaper, radio, television) for student quotes, interviews and pictures. Occasionally, the school, the Board, or the Department may record audio or video images of students for teacher professional development or curriculum support projects. All this information may be published or aired. As well, our School Board’s Communication Office may contact students for quotes, interviews or photographs for board communications, websites or publications. You permission is required for the above to take place. Please check off the following items to indicate your willingness for your child to participate. Students and Parents: Please sign below. Check: ____ Artwork for display/publication (including the Department of Education, board, school and teacher websites). ____ Written work for display/publication (including the Department of Education, board, school and teacher websites). ____ Digital work for display/publication (including the Department of Education, board, school and teacher websites). ____ Involvement in media reports/interviews. ____ Non-identifying photographs of student on school and board websites. ______________________________________________________________________________________________ Student Name (Print Please): _________________________________ Grade:_____________________ Student Signature: _____________________________________________________________________ Parent/Guardian Signature (s): ___________________________________________________________ Date: _______________________________________________________________________________ *Note: Besides the student, only persons having lawful custody of the student may sign this consent form as parent or legal guardian. If both parents have lawful custody, one or both may sign.