Camp Wanakita Registration

Registration is now open for Camp Wanakita 2012! To register, complete the form below – do not register directly through Camp Wanakita. There is no fee to attend Camp Wanakita if your child has a bleeding disorder. Capacity is limited so please register soon - the deadline is February 1, 2012.

Camp Wanakita, located near Haliburton, Ontario, is open to all children and youth from 7 to 16 years of age. It provides an opportunity to participate in fun activities in a safe environment while meeting other children with and without bleeding disorders. With the help of six hemophilia nurses from across the province, children with bleeding disorders learn to self-infuse at camp and successful first time infusers will take home a video to show their parents.

Campers have the choice of attending for one or two weeks.
Camp Wanakita 2012 dates:
Period C1 July 29th – Aug 4th
Period C2 Aug 5th – Aug 11th
Period C July 29th – Aug 11th
Period CD July 29th – Aug 25th
Period AB July 1st – July 28th

For more information about the Camp Wanakita facilities, see their website. If you have any other questions or concerns, contact Jeenetha Kulasingam at 1-888-838-8846 extension 14.

For more information about the Camp Wanakita experience parents and guardians may view the camp videos found below.

Part One:

Part Two:



*required fields

Camper Last Name:	*
Camper First Name:	*
Period:	Please Choose C: July 29 C1: July 29 C2: August 05 CD: July 29 AB: July 1 * Session AB is only for campers who attended last year's Student Councilor Training session during that period.
Session:	Please Choose 1 Week Junior 2 Week Junior 1 Week Intermediate 2 Week Intermediate Senior Traditional Senior Specialty *
Specialty:	Please Choose 1st Yr SC 2nd Yr SC *
Age at Camp:	*
Date of Birth (YYYY-MM-DD):	*
School Grade completed as of June 2012:	*
Request for Cabin Mates:
Transportation to Camp:	Please Choose By Own vehicle OEOR Bus Bus from Hamilton – Mohawk College Bus from Burlington – Appleby Go Station Bus from Toronto – Hwy 400 North Service Station Bus Service from Airport *
Transportation from Camp:	Please Choose By Own vehicle OEOR Bus Bus from Hamilton – Mohawk College Bus from Burlington – Appleby Go Station Bus from Toronto – Hwy 400 North Service Station Bus Service from Airport *
Laundry Service:	Please Choose No. 1 - $18.00 No. 2 - $36.00 No. 3 - $54.00
Tuck Shop:	$
Street Address:	*
City:	*
Province:	Alberta British Columbia Manitoba New Brunswick Newfoundland Northwest Territories Nova Scotia Nunavut Ontario Other Prince Edward Island Quebec Saskatchewan Yukon *
Postal Code:	*
Home Telephone:	*
E-mail Address:	*
1st Parent Name:	*
1st Parent Work/Cell Telephone:
2nd Parent Name:
2nd Parent Work/Cell Telephone:
Emergency Contact (Name):	*
Emergency Contact (Telephone Number):	*
Camper Health Card Number:	*
Other Health Insurance Information:
Custody (if other than both parents joint):
Family Physician Name:	*
Family Physician Telephone:	*
Height (in cm):
Weight (in pounds):
Immunizations:	Please Choose Yes No * Has the camper been immunized against diphtheria, mumps, polio, red measles, tetanurubella, and s in accordance with the recommended immunization schedule in Ontario?
Allergies/Reaction:
Medications/When to be administered:
Condition and Date of Onset:
Dietary Information:
Special Needs: