Marpole Oakridge Community Centre

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Marpole-Oakridge Community Centre 990 West 59th Avenue, Vancouver, B.C., V6P 1X9 Phone 604-257-8180 Fax 604-257-8179 This attachment to the legal waiver obtains approval from the parent/guardian for their child to participate in the weekly listed activities. Youth Summer Leadership Camp 2016 Activity Consent Form Child’s First and Last Name: Male Female Parent/Guardian: Please sign your initials for each week your child is registered in. Youth Summer Leadership Camp Scheduled Out Trips: Parent/Guardian Initial Required (PT) – Public Transportation (W) – Walking (CB) – Chartered Bus Week 1 – Queen Elizabeth Park (PT), Playland (PT) Week 2 – Swimming @ Hillcrest Pool (PT), Exit The Room (PT), Workshop at Killarney CC (PT) Week 3 – Kitsilano Pool (PT), Kayaking at Jericho Beach (PT), Workshop at CHCC (PT), Community Clean Up – Marpole Neighborhood (W) Week 4 – Deliver Care Packages in the Downtown Eastside (PT/W), VPL Downtown Library (PT), Rogers Arena Tour (PT), Lonsdale Quay Summerfest (PT), VPD Workshop Mt Pleasant CC (PT) Week 5 – Splashdown Waterslides (PT/CB), Volunteering - Paint Out @ Mt Pleasant (PT) Week 6 – Town N’ Country Bowling (PT), Workshop at CHCC (PT), Photography Project – Marpole Neighborhood (W) Week 7 –Stanley Park Bike Ride (PT), Art Start Tour (PT), Ice Skating @ Sunset CC (W), Workshop at Strathcona CC (PT) Week 8 – The Fair at the PNE (PT), Seymour Creek Golf Centre (PT) Swimming Ability: Good_________ None:_________ Level:__________________________ I understand the following alternate activities may occur due to rainy days or other necessary scheduling changes: Cineplex Marine Gateway , Country Town Bowling, Hillcrest Pool, Dodgeball , Maple Grove Pool, Winona Park. My son/daughter (8yrs+) can walk to the centre/return home by himself/herself: YES______ NO_______ Authorized pick up contact person(s): ______________________________________________________________________________________________________ ______________________________________________________________________________________________________ By signing this form I agree that my child may attend the out trips initialed above. Signature of Parent/Guardian: ______________________________________ Date: _____________ Jointly Operated by Marpole-Oakridge Community Association & Vancouver Board of Parks and Recreation .

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