Camp Registration - CHAOS Summer Camps Ltd.

Registration Form

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Reserve a Spot

Secure Your Spot for Summer Fun today!

Camp Details

Inclusive Early-Drop/Pick-up (7:00am & 4:30pm, Basketball Camp 8am-4pm)
Soccer: Camp Ball and Tshirt,
Hockey: Practice Jersey and Tshirt,
Basketball w Coach Derick Bulley: Camp Tshirt
Experienced teachers as instructors/supervisors
Daily Challenges/Competitions

Beckwith Recreation Complex

July 8-12 – Soccer Camp
July 15-19 – Soccer Camp
July 29-Aug 2 – Soccer Camp
Aug 12-16 – CHAOS Hockey Camp

Stittsville

July 15-19 – Chaos Basketball with Coach Derick Bulley @ Stittsville Public School (9-3pm)
July 22-26 – Soccer Camp @ Cardel Rec Complex

Carp Soccer Fields

July 2-5 – Soccer Camp

Parent/Guardian Information

– Contact information – Address – Emergency contact information

Parent/Guardian First Name(Required)

Parent/Guardian Last Name(Required)

Email(Required)

What is your relationship with the participant?(Required)

Phone Number – Primary(Required)

Phone Number – Secondary

Participant Home Address(Required)

Street Address City Province Postal Code

Emergency Contact Person(Required)

Emergency contact person relation to participant(Required)

Emergency contact person phone number(Required)

In the event of an emergency (i.e., inclement weather, injury) you give permission to contact via text message at:(Required)

Primary phone number

Secondary phone number

Neither primary nor secondary number

Camper Information

If registering multiple campers, please resubmit this for for each individual.

Participant First name(Required)

Participant Last name(Required)

Participant Date of Birth(Required)

MM slash DD slash YYYY

Participant Gender Identity(Required)

Male

Female

Is there any information that would serve the camp staff well to understand about your participant? If so, please include some details below

Medical Information

To best support your child, please help us understand any medical concerns, if a concern exists.

If any medical conditions were disclosed above, please use the space below to communicate the information specific to the concern.

Are you disclosing any of the participant's specific medical conditions or allergies?(Required)

Asthma: Puffer on-site

Asthma: Managed (No puffer)

Diabetes: Blood sugar monitoring required

Diabetes: Assistance administering insulin

Diabetes: Dietary support/reminders required

Allergies: Food

Allergies: Insect

Allergies: Epinephrine on-site

History of seizure disorder

Heart condition/abnormality

Physical/Cognitive exceptionality

Medication support required

Recent injuries (strain/sprain/concussion)

Chronic condition

Emotional/behavioural concerns

Other (please highlight details below)

No medical concerns

Others (please specify)(Required)

Consent and Waivers

Terms and Conditions(Required)

You acknowledge that you have read, understand and agree to, the terms and conditions for parents/guardians.

Please review at: https://www.chaosacademy.ca/terms-and-conditions/

Rowan's Law Awareness(Required)

You acknowledge that you have read, understood, and agreed to the terms and conditions of this waiver, including my awareness of Rowan’s Law.

Please review at: https://www.chaosacademy.ca/rowans-law-awareness/

Media Release Policy(Required)

You acknowledge that you have read, understood, and agreed to the terms of our media release policy.

Please review at: https://www.chaosacademy.ca/media-release-policy/

Cancellation Policy(Required)

You acknowledge that you have read, understood, and agreed to the refund policy outlined above.

Please review at: https://www.chaosacademy.ca/cancellation-policy/

Liability Waiver and Release Agreement(Required)

By checking the box below, I acknowledge and accept the risks associated with participating in Chaos Academy Summer Camps. I agree that Chaos Academy, its staff, and affiliates are not liable for any injury, loss, or damage arising from participation in the camp activities, except where such injury, loss, or damage is a direct result of the company’s gross negligence or intentional misconduct. I understand that this waiver includes all camp-related activities, regardless of location, and I agree to abide by all camp rules and instructions provided by camp staff.

Summer Camp – Select below

There are a few options for camp registration. Please select the option below that best suits.

If you select a “Pay Manually” option, cash/e-transfer can be made the day of in the event that a player wants to return for another day beyond the initial selection made on this form.

Mini Masters (U5/U6)(Required)

N/A

Mini Masters options(Required)

Closed – July 2-5 (Carp, 4-day)

[Sold out] – July 8-12 (Beckwith)

[1 spot left] – July 15-19 (Beckwith)

[4 spots left] – July 22-26 (Stittsville)

[2 spots left] – July 29 – August 2 – (Beckwith)

Tag Masters (U7/U8)(Required)

N/A

Tag Masters option(Required)

[1 left] – July 2-5 – (Carp, 4-day)

[sold out] – July 8-12 – (Beckwith)

[4 left] – July 15-19 – (Beckwith)

[5 left] – July 22-26 – (Stittsville)

[6 left] – July 29 – August 2 – (Beckwith)

Skill Academy (U9/10/11)(Required)

N/A

Skill Academy option(Required)

[1 left] – July 2-5 – (Carp, 4-day)

[sold out] – July 8-12 – (Beckwith)

[5 left] – July 15-19 – (Beckwith)

[8 left] – July 22-26 – (Stittsville)

[10 left] – July 29 – August 2 – (Beckwith)

Junior Academy (U12/U13/U14)(Required)

N/A

Junior Academy option(Required)

[1 left] – July 2-5 – (Carp, 4-day)

[3 left] – July 8-12 – (Beckwith)

[3 left] – July 15-19 – (Beckwith)

July 22-26 – (Stittsville)

[4 left] – July 29 – August 2 – (Beckwith)

CHAOS Hockey Camp (Aug 12-16 only)(Required)

N/A

CHAOS Hockey Camp(Required)

[13 left] – Girls (U8-U11)

[10 left] – Boys (U8-U11)

CHAOS Basketball Camp (July 15-19, 2024)(Required)

N/A

CHAOS Basketball Camp Option(Required)

Chaos Boys U12-U14

Chaos Girls U12-U14

Checkout

Total

How would you like to pay?

Pay Online

Pay Manually (eTransfer)

Credit Card

Send email transfer to play@chaosacademy.ca and please include the name of the attendee in the notes

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