PA Day Camp, Willowjays

pa day Gymnastics camp at willowjays

9 am to 4 pm

Our Day Will Consist Of A Variety of Gymnastics, Sports & Games, Arts & Crafts, Nature Walks, Singing & Dancing + More

$55 / day

PA DAY CAMP REGISTRATION FORM *

October 20th, 2025
After Care

4pm - 5pm ($12)
Parent/ Guardian Name *

First

Last
Address: *
Phone Number *
Email Address *
Child Name *

First

Last
Age (4-7) *
Gender *
Child Name 2

First

Last
Age (4-7)
Gender
Emergency Contact Name & Phone Number *
Doctor's Name and Phone Number *
Medical Concerns
Does your child have any allergies, medical concerns, or food restrictions that we should be aware of? *
If any please tell me about them here
Does your child carry an EpiPen? *
Anything else you would like to tell us ?
I hereby grant permission for Willowjays to use photos and/ or videos of my child for the use of promotional material. *

I give consent for my child to be photographed for promotional purposes I do not give permission for my child to be photographed
Informed consent agreement: Print Your Name and the date *

I, the undersigned, hereby agree to indemnify and save harmless Willowjays Co. of Sunderland, their/ its employees, members and coaches from all claims, demands, damages, actions, suits or proceedings arising out of participation of myself/my child, named above, in any activity. I, the undersigned, hereby acknowledge that certain risks of injury are inherent to participation in hand on science, arts & crafts, outdoor play and physical activity. These types of injuries may be minor or serious and may result from one’s own actions, or the actions of others, or combination of both. I, hereby warrant that my child is physically fit and medically capable to participate and understand that the choice to participate brings with it the assumption of those risks and results which are part of the activities held at Willowjays. I agree to allow my child to receive basic first aid/ medical care from the instructors certified in first aid if necessary. Willowjays has my permission to use pictures and quotes for promotional material in print and electronic format, including to their website or other social media platforms. If you do not wish for your child’s photograph to be taken please notify Willowjays in writing. I declare having read and understand the above informed consent agreement in its entirely and hereby consent to participate acknowledging all the foregoing. I also certify that the information provided above in this form is true and correct.
Bill 186, Growing Agritourism Act, 2024: Print your name and date * *

WARNING: under Ontario law, an agritourism provider is not liable for the death or injury or illness of a participant in an agritourism activity conducted at this agritourism location if that injury or death or illness results from the inherent risks of that agritourism activity. Inherent risks of agritourism activities include, but are not limited to, the risk of injury inherent to land, equipment and animals as well as the potential for you as a participant to act in a negligent manner that may contribute to your injury or death. You are assuming the risk of participating in this agritourism activity. https://www.ola.org/en/legislative-business/bills/parliament-43/session-1/bill-186
PAYMENT OPTIONS *

Cash to be dropped off at the house

Where We Are

10430 Sideroad 17

Sunderland, ON

L0C 1H0