Camp Eagle Nest 2017
Camper Application Form

Please call us at 705-923-6244 if you have questions or would like assistance filling out this form. You can also download a PDF version by clicking here and return it by mail, fax, or e-mail.

Name *
Name
Address *
Address
Phone *
Phone
Alternate phone
Alternate phone
Please select the camps you are interested in attending below
Cultural Camps for Youth
Enjoy hiking, paddling, outdoor cooking, arts, crafts, and sports while also deepening your knowledge of Native cultural teachings, songs, stories, language and ceremonies in the beautiful Benny Forest. Enjoy the fresh air, wholesome food cooked on an open fire, and sleep in a beautiful large tepee. Campers must be at least 9 years of age or accompanied by an older family member who also participates. Each participant will be guided in making their own traditional arts & crafts such as drums, flutes, shakers, paintings and jewelry to take home. $375 per person plus tax, six nights/ seven days.
Junior Camps
Come out to a specially designed arts and waterfront camp for younger campers based in the beautiful Benny Forest, Ontario. Sleep in a tepee or cabin, go on excursions by land and canoe, join in group games and scavenger hunts, learn traditional and new age stories, songs, crafts and more.
Canoe and Wilderness Skills Training Camps
Come out for a series of weekend camps to gain Anishnaabe qualifications and prepare for employment as a camp counselor or canoe trip leader next summer. Anishnaabe training is provided on weekends by Elder Art Petahtegoose and others.
Emergency Contact Information
Applicants MUST provide 2 separate emergency contacts living at different addresses (grandparent, neighbour, friend, etc., who will be available when camper is on trip).
Emergency Contact #1 *
Emergency Contact #1
Applicants MUST provide 2 separate emergency contacts living at different addresses (grandparent, neighbour, friend, etc., who will be available when camper is on trip).
Phone *
Phone
Phone 2
Phone 2
Emergency Contact #2 *
Emergency Contact #2
Phone *
Phone
Phone 2
Phone 2
Questions to be filled out by camper
Camper-Staff Agreement
To be read and signed by campers. Check each box to indicate you understand and agree.
Camp Eagle Nest staff and campers will follow these principles on trip:
Camper Waiver
CONSENT AND LIMITATION OF LIABILITY FOR CAMP EAGLE NEST (To be filled out by campers themselves if age 18 or over, or by their parent or guardian if under 18)
Camp Eagle Nest is an Ontario non-profit corporation that offers a variety of wilderness camping and cultural experiences to its members. Our camps may involve vigorous exercise in wilderness areas where outside assistance may not be immediately available. While our staff receive training in first aid and emergency procedures, and are obligated to follow our safety policy, the nature of the activities means that accidents are still possible. Camp Eagle Nest and its staff cannot be held responsible for accidents that happen despite our reasonable efforts to avoid them. Furthermore, Camp Eagle Nest is not responsible for incidents arising from failure of the camper to obey the instructions of staff or to leave the group for any reason without permission from the trip leader. By signing the form below you confirm that you are aware of the nature of the program and the risks involved, and that you agree to not hold Camp Eagle Nest and its staff liable for injury and/or property damage or theft. If you have any questions or concerns about the nature of the program or the risks involved, call Camp Eagle Nest at 705-690-3844 before signing this form. It is your responsibility to ensure that the camper is physically and emotionally able to participate in Camp Eagle Nest.
I am over 18 years old and agree that:
I have read, understand, and agree to all of the above.
Date
Date
Medical Information Form
Camp Eagle Nest may involve a wilderness trip, sometimes several days away from a medical doctor or hospital. A full and complete medical history is necessary to plan a safe and enjoyable trip. All information in this form is kept confidential within the administrative and tripping staff. Please ask us if you have any questions about this form. If possible, 6 have the camper see a doctor for a general check-up before their trip. If you are unsure about any of this information please contact a doctor. We require ALL information on this form to be complete before the camper goes on trip.
Birth Date
Birth Date
Does the camper smoke?
Does the camper have guardian permission to smoke on trip?
Has the camper wet their bed in the last three years?
(Depending on the time of year and other factors this may present a safety concern)
(The camper must have a valid tetanus shot, within the last 10 years, to go on trip. If necessary, see a doctor to update it for no cost.)
If so list the medication, its purpose, the schedule and dose taken, and possible side effects for each below:
If yes, please describe and list any treatments:
We carry the following over-the-counter medications in our first aid kits. Please mark if the camper is allergic to, has an adverse reaction to, or otherwise should not be given:
If so list the allergy source, the camper’s symptoms, normal severity, and treatment below.
If yes, please describe:
If yes, please describe:
If yes, please describe and list any treatments:
Does the camper have any of the following:
Doctor's Phone Number:
Doctor's Phone Number:
Camp Eagle Nest reserves the right to evacuate and/or deny canoe trips to any camper judged by the Camp Outlook staff to be ill, in poor health, or presenting unacceptable (threatening, negligent, or dangerous) behaviour upon arrival at Camp, on the way to the camp, or while at the camp. In such a case, the camper will be returned home and their guardian will be notified.
Signed on:
Signed on:
Signed on:
Signed on:
Please return this form, along with a deposit of half of full fee. Your deposit will be returned (minus $50 processing fee) if a cancellation occurs at least two weeks before camp. Cheques may be made out to Camp Eagle Nest and mailed to: Camp Eagle Nest, Box 104, Cartier ON P0M 1J0. E-mail transfer to campeaglenest@gmail.com is also accepted. Funds may also be sent through paypal on our website: www.campeaglenest.com. Scanned application forms can also be sent to campeaglenest@gmail.com and copied to ronson.mcnichol@gmail.com. We will notify you as soon as your application form has been received. We would like to interview the applicant in person or over the phone if possible before confirming their placement in a particular camp session. We will let you know whether there is space in the camp of your choice