Camper Applicaton

PLEASE PRINT CLEARLY - THIS IS THE CAMP’S PERMANENT RECORD.
COMPLETE ALL BLANKS ON BOTH SIDES OF APPLICATION

Camper Last Name

Camper First Name

Gender

FAMILY INFORMATION (Applies only to the Parents / Guardians with whom the camper resides - Non
custodial Parent Information is required below)

• Title (please check one)

• Mr. & Mrs.

• Mr.Only

• Dr. & Mrs.

• Mr. & Dr.

• Dr.

• Other

Last Name

Father

Last Name

Mother

Home Address

First Name

First Name

City

Home Phone

Other Home Phone

Province/State

Work Phone

Work Phone

Postal Code / Zip Code

Cell Phone

Cell Phone

Country

Cottage / Summer Phone

Fax Number

E-Mail Address

Is the non-custodial parent to

• Be contacted in the event of an emergency?

• Receive duplicate mailings?

• Receive the invoice?

If you checked any of the above, please provide all of the following pertinent information:

Title Name

Home Phone

Other Phone

Address

City

Province / State & Postal Code / Zip Code

CAMPER INFORMATION Birthday (Month / Day / Year)

School

Health Insurance Number

Emergency Contact (Other than Parents)

Camper’s Physician’s Name

Relationship to Camper

Home Phone

Physician’s Phone Number

Work Phone

Cell Phone

PERSONAL INFORMATION

Cabin Grouping Requests - Please note that campers are grouped according to the order in which
applications are received and are based upon grade and age. Placements are done at the discretion of the Director, although all requests are taken into consideration. We are unable to honour negative requests
unless all parties are notified. Please don’t put the camp in an unfair position.

First Choice
(one person only)

Additional Requests
(2 Maximum)

Confidential Information - Parents must disclose all medical, behavioural and personal information
pertaining to their camper to ensure that we can provide the best possible care and experience
for them at camp (including; bedwetting, eating disorders, sleep difficulties, bullying issues, daily
medication requirements, difficulties in school or with a divorce or death in the family, previous bad camping experience, etc.).

Dietary Information - Torolago prides itself on the quality of food service that is provided. Our dining
hall is kosher and nut-safe. We are able to accomodate most dietary needs easily. Campers with serious
dietary restrictions or allergies must contact the camp to discuss menus and possible meal substitutions.
Please indicate if your camper has the following dietary restrictions or allergies:

• Vegetarian

• Lactose intolerant

• Peanut Allergy

• Dairy Allergy

• Other

Credit Card Authorization - I authorize Torolago Inc. to charge camper’s summer fees, plus extensions
or extras (prescriptions, dental fees, etc.) to my credit card.

• Visa

• MasterCard

• Card Number

• Expiry Date

• Other

Conditions of Enrollment

Camper applications must be made in writing and are confirmed in the order received. We cannot
accept telephone or other verbal reservations. Applications cannot be confirmed unless accompanied by a
$500.00 deposit for each child.  Campers that depart camp for breach of policy (policies can be found
on the Torolago guide on our website) do not receive a refund. I agree to allow my child to participate
in the full camp program and all activities and supervised trips or activities not on camp property.  If for
any reason my child requires medical attention beyond that furnished by the camp or by my own personal
health insurance, I agree to be responsible for any additional expenses incurred. I also give the owner
the authority to act on my behalf in case of a medical emergency.  I hereby consent to allow Camp
Torolago to use my child’s photograph or video image for publicity purposes.  I have read and agree to
the above Conditions of Enrollment and acknowledge that it is my responsibility to be familiar
with all registration materials, policies, guidelines and details provided by the camp.