BGC Summer Programs at VSB

Program Dates: July 2 – August 22, 2025 (Closed on June 30, July 1, August 4)

Program Time: 8:30am – 2:30pm

    School Attending

    Please select the school you will be attending:

    Child's Information














    Household Information








    Parent/Caregiver 1













    Parent/Caregiver 2


















    Optional Demographic Information









    Emergency Information (not a caregiver listed above)

    Emergency Contact #1 (Not parent/Caregiver listed above)






    Emergency Contact #2 (Not parent/Caregiver listed above)






    Child's Medical Information

    Please outline any and all allergies your child has:

    Type (drug, food, environmental, insect, other)

    Allergen (please be specific)

    Type and Severity of Reaction (indicate if life threatening)

    Management, Treatment/Medication

    Date of Last Reaction








    ADD/ADHDNeonatal Abstinence SyndromeBehavioural ConcernsConcussionDevelopmental DelaysEpilepsy/SeizuresHay FeverMental Health ConcernsMotion SicknessBlackouts/FaintingFetal Alcohol SyndromeNose Bleeds











    Health Acknowledgement


    Behaviour Agreement






    Description of Activities and Inherent Risks








    Consent/Acknowledgement of Risks

    Rules

    Publicity and Privacy

    Consent/Publicity

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