pender island aug 4-8
e-transfer

Registration for 1 child or up to 2 additional siblings

Thank you for your choosing to attend our summer camp!
Before you proceed in registering, we kindly ask you to go over an online copy of our linked forms below and revisit them any time after the registration:

Health and Wellness Expectations

Behavioural Trends Form

Codes of Harmony Form

We also understand that our Health and Wellness Code and Harmony codes might be a long read, so
Our lead mentor will arrange a time to have a 20 min phone chat with you after registration to see how well they sit with you, and how we can provide the best experience for your family at camp. A phone call is a necessary step for enrolment into our nature camps, and you will have an option to provide a date and time suitable for you at the bottom of the registration form.
If in any case, we cannot accept your child's attendance before camp due to any reason that is our responsibility, such as we cannot provide a trained one-on-one mentor for autism or other learning and behavioural difficulties at this time of camp, then we will refund you fully after the phone call-
provided you have given us honest information on the behavioural challenges that your child has.
No refunds are applied during the time of camp if the Codes of Harmony are continuously broken over the week, such as physical bullying, and your child has to be sent home for those reasons during camp week.

However we welcome all to apply as we have helped many children with difficulties integrate seamlessly into their best versions of themselves and work through issues through self directed resolution under our mentorship. The phone call with you helps us immensely determine whether we have the resources to successfully integrate your child in our 2025 camps.

Click here to read our New Health and Wellness Codes for 2025

Click here to read our Codes of Harmony

Click here to open our reasons why for our Behavioural Trends Form, and to revisit the questions anytime after registration

part 1. Personal information

Child's First Name

Parent/Guardian First Name

Parent/Guardian Email

Child's Last name

Parent/Guardian Last name

Parent/Guardian Phone Number

Emergency Contact Full Name + Relationship to Child

Phone

2nd Emergency Contact Full Name + Relationship to Child

Child Home Address

Sibling attendance for same camp week with same guardianship, home address, and family doctor- Please write full name and date of birth if applicable

Phone

Child Date Of Birth

Sibling attendance for same camp week with same guardianship, home address, and family doctor- Please write full name and date of birth if applicable

Part 2. medical information

Family Doctor Name and Address

Child 1 Health Number/Medical Insurance

Sibling Personal Health Number/Medical Insurance

Does your child require any special medical assistance at camp, i.e epipen/allergy medication- please detail below

(SIBLING ONLY) Does your child require any special medical assistance at camp, i.e epipen/allergy medication- please detail below

Part 2. Behaviour trends-
Please write a description, as well as a number from 1-5, 1 being not alot, to 5 being extremely well
For multiple sibling registrations in the same house house address, please write each child's name in the description next to your written reply

Does your child need continual one-on-one support in other schools? 1 2 3 4 5

Has your child had any problems at other schools or camps? 1 2 3 4 5

How well does your child socialise with others? 1 2 3 4 5

How well does your child respond when they don't get their way? 1 2 3 4 5

What environments do they respond well to when they are reactive?

Is your child likely to join in on new activities? 1 2 3 4 5

What interests your child in nature?

Does your child prefer emotional, intellectual or physical stimulation or other? 1 2 3 4 5

Do they find certain activities that require emotional/intellectual/physical efforts challenging/ or will not participate in?

What games do they love?

How well can your child swim? Do you allow them to participate in wading in the ocean under supervised mentorship?

Is there anything else you’d like to share that will help us co-create a comfortable experience at Aliannah Earth School nature camp?

Thank you for your caring response. We really appreciate your effort in walking hand in hand to provide a great experience at nature school for your loved one(s). At Aliannah we want to take this a step further after your registration and have a 15 minute phone call with you, so we can both feel confident this nature camp is a great fit at this time.
(Please select a date and time, and contact method+ time zone below for when you've available for a phone chat)

Please select a date when Aliannah can reach out to you

Please pick a time for a 15 minute phone chat

What is the best phone number(s) to reach you on? What time zone are you in? If your selected time doesn't work, what time frames are you availble in the week/ or weekend?

Part 4. Waiver and agreements

I have read the school waiver and am aware of the risks and danger my child(ren) can encounter at Aliannah Earth School Summer Camp

I accept terms & conditions

Select date signed

I have read the Aliannah Health and Wellness Code linked at the top of this page

I would like the option to purchase a stainless steel water bottle from Aliannah for my child to bring to camp

I have read and agreed to Aliannah's Code of Harmony with my child, found and linked at the top of this page

Your Signature

I want to subscribe to the newsletter.

Part 5. Payment fees

Please e transfer $330/child/week for Pender Island Aug 4-8 to eagle@aliannahearthschool.org

Thanks for submitting! Detailed instructions for pick up and drop off will be emailed closer to the start date. We look forward to welcoming you in our phone call!

pender island aug 4-8 e-transfer Registration for 1 child or up to 2 additional siblings