Helping Hands Interest Form

Helping Hands provides 1:1 support to children ages 4-13, who require additional assistance in order to participate in camp programming:
-Due to high demand, spaces are limited to 2 consecutive weeks.
-Spaces are limited and you are encouraged to submit this interest form as soon as possible.

Please complete this interest form and someone from the Inclusion Team will respond confirming a space or spot on the wait list. Submitting this form does not guarantee a space, registration will not be completed until you receive conformation. Due to volume of interest, please allow 1-2 business days for response.

Child's Information

Child's first and last name. (If more than one sibling for Helping Hands, please list all)

Child's birthdate

If applicable, second child's birthdate

	Please select the preferred camp location
Chippewa (Ages 6-13; operates all 9 weeks)	Chippewa (Ages 6-13; operates all 9 weeks)
Eco-Explorers (Ages 8-11; operates weeks 1-8)	Eco-Explorers (Ages 8-11; operates weeks 1-8)
Canoe Skills (Ages 8-13; operates weeks 1-8)	Canoe Skills (Ages 8-13; operates weeks 1-8)
Fundamentals (Ages 10-13; operates weeks 1-8)	Fundamentals (Ages 10-13; operates weeks 1-8)
Tansley Woods Stepping Stones (Ages 4-5; operates weeks 1-9)	Tansley Woods Stepping Stones (Ages 4-5; operates weeks 1-9)
Tansley Woods Sports of Kidsventure (Ages 6-13; operates weeks 1-9)	Tansley Woods Sports of Kidsventure (Ages 6-13; operates weeks 1-9)
Queen Victoria Stepping Stones (Ages 4-5; operates weeks	Queen Victoria Stepping Stones (Ages 4-5; operates weeks
Queen Victoria Sports of Kidsventure (Ages 6-13 ; operates weeks 1-7)	Queen Victoria Sports of Kidsventure (Ages 6-13 ; operates weeks 1-7)
Allan A Greenleaf Stepping Stones (Ages 4-5; operates weeks 1-7)	Allan A Greenleaf Stepping Stones (Ages 4-5; operates weeks 1-7)
Allan A Greenleaf Sports or Kidsventure (Ages 6-13; operates weeks 1-7)	Allan A Greenleaf Sports or Kidsventure (Ages 6-13; operates weeks 1-7)

Please note: Chippewa, Canoe, and Fundamentals are located at Christie Conservation Area. Indoor locations that do not have bussing provided are as followed: Tansley Woods, Queen Victoria and Allen A. Greenleaf.

	Please indicate the two week block you are interested in. If you only require 1 week, please select week 9.
Week 1 & 2 (July 4 - 15)	Week 1 & 2 (July 4 - 15)
Week 3 & 4 (July 18 - 29)	Week 3 & 4 (July 18 - 29)
Week 5 & 6 (August 2 - 12)	Week 5 & 6 (August 2 - 12)
Week 7 & 8 (August 15 - 26	Week 7 & 8 (August 15 - 26
Week 9 (August 29 - September 2)	Week 9 (August 29 - September 2)
Flexible with dates	Flexible with dates

Caregiver Information

First & Last Name

Phone Number

Third Party / Agency Information

If you are a third party supporting a family with registration, please enter your full name, agency, phone number and email.

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