Camp NKN 90th Anniversary

Your camp fees may be paid in advance or when you arrive at Camp. Please make bursary requests to your program Director. Camp Program Directors will finalize the total in case of adjustments.

To pay by interac e-transfer, send to neekaunis- assistant-treasurer@quaker.ca, and put NeeKauNis Fees and the name of the Camp Program in the message line of your email. Autodeposit is on so there is no need for a password.

To pay by cheque, mail to Camp NeeKauNis c/o 91a Fourth Ave., Ottawa, ON K1S 2L1

How many people are you registering? *

(including yourself)
Fill in your registration information on this page. If you are registering additional people, you will be able to enter their registration information after you complete this page and click "Review your registration".

Camper Name and Address

First Name *

Last Name *

Birth Date

Gender

Female Male Other

Street Address *

Street Address Additional Line

City *

Province/State *

Postal Code *

Country *

Home phone *

Cell phone

Email *

Camper Medical Information

When completed, this information will be kept confidential. It will be used by the camp director, emergency responders, healthcare providers, and camp staff, solely on a “need-to-know” basis. It is optional for adults.

Directors will maintain custody of medications for your minor, unaccompanied child. Please provide instructions for their use, even in the case of self-administration.

Which medications if any, is this camper taking

Please note that due to our volunteer staffing, Camp NeeKauNis cannot provide 1 on 1 support for persons regularly requiring support at home or elsewhere. Camp NeeKauNis waives fees for accompanying paid persons.

List any significant allergies (e.g. medications, latex, or food)

In order to have information at hand in case of an outbreak, we will ask on the registration form registrants to indicate vaccination status based for MMR (measles, mumps, rubella), DTPP (diphtheria, tetanus, pertussis, polio), MenC (meningococcal disease), and chicken pox, CoVID-19 vaccinations and boosters for all attendees according to age-limits and appropriate exemptions.

Does the Camper have up to date vaccinations listed above. *

Yes No

Is there any other medical information we should have about this camper that will help us to ensure her/his safety and well being while at Camp or in the case of emergency?

Other medical information

Fees are waived for any accompanying paid support person.

Family physician name and phone number

Emergency Contact

Important! This is a person Camp personnel may contact in case of emergency.

Emergency Contact Name *

Emergency Contact Relationship *

Emergency Contact Phone Numbers *

Emergency Contact City and Province *

Food

Camp cooks are committed to accommodating dietary requirements when they receive pertinent
information in advance of menu planning. They do their best to accommodate a multitude of
requested preferences, but will not always be able to do so. Your understanding is appreciated!

Please list any food allergies and severity.

Food Allergies and Severity

Please list any food sensitivities and severity.

Food Sensitivities and Severity

Dietary Preference

Add any further diet details the cooking staff will need to know.

Dietary Details