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LAKEFIELD CAMP INTERNATIONAL
A CANADIAN CAMP EXPERIENCE YOU CAN CALL YOUR OWNLakefield Camp International welcomes campers for an unfortgettable summer of learning, recreation, and friendship in the beautiful
Kawartha Lakes region of Ontario. Operating on the stunning grounds of Lakefield College School, our camp offers students a variety
of course options. Campers take advantage of modern classrooms, well-equipped athletic facilities, expansive playing fileds, and direct
waterfront access. Sports and arts programming may be combined with traditional ESL instruction or one of our innovative specialty
programmes.
Dates 7 weeks: June 30 - August 17
LocationLakefield, Ontario (near Peterborough)
Campus Private High School Campus
Gateway Toronto, Ontario (YYZ)
Ages - Camp 9-16 • Boys & Girls
Ages - Leader in Training 17 • Boys & Girls
Capacity 175
AccommodationSchool Residence Double or Triple room
Meals 3 meals daily + evening snack
Programme Options
General English 10hrs/wkGeneral English 15 hrs/wkWilderness Education 10hrs/wkEnglish through Drama 10hrs/wkActivity Camp Leader in Training (LIT)
Activities Daily - various
Included Excursions1 Full Day Toronto excursion every 3 weeks
Optional Excursions Available weekly
Study Permit Not required
Individuals Accepted
Groups Accepted
Group LeadersAcceptedAccommodated on campus
REGISTRATION FOR ENGLISH, WEP, DRAMA OR ACTIVITY CAMP REQUIRED AT TIME OF BOOKING
OVERVIEW
MAIN FEATURES • Traditional summer camp with benefit of residential accommodation and modern facilities• Specialty programming: General English, English through Drama and Wilderness Education Programme • Leadership Training programme for 17 year olds
• Group bookings available
AGES 9-16 LIT-17
ONTARIO
Lakefield
Toronto
DATES 2019 7 weeks DEPARTURE DATE (by session length)
SATURDAYS
ARRIVAL DATE
SUNDAYS 4 weeks 3 weeks 2 weeks
June 30 July 27 July 20 July 13
July 07 August 03 July 27* July 20
July 14 August 10 August 03 July 27
July 21 August 17 August 10 August 03
July 28 xx August 17 August 10
August 04 xx xx August 17
* Leader in Training session
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LOCATIONThe village of Lakefield is located close to the city of Peterborough, approximately 150km northeast of Toronto. Lakefield sits on the southeast shore of Lake Katchewanooka, and is part of the Kawartha district of Ontario, a region rich in natural beauty and home to many private cottages and resorts. The camp operates on the grounds of Lakefield College School, a prestigious Canadian private boarding school.
Distances from campus:• Pearson International Airport (YYZ) = 150 km• Niagara Falls = 280 km
NEARBY AMENITIES• Village of Lakefield is within walking distance of camp• Walk-in Clinic - 2.5 km from campus in Village of Lakefield • Hospital - 18 km from campus in Peterborough
ACCOMMODATION: RESIDENCE HOUSESResidence houses each vary in terms of size. Rooms have 2-3 beds, Common bathrooms with multiple toilets and showers are on each floor. Girls and boys are in different houses, with staff living on each floor.
Residence Room includes: 2-3 individual beds, desk, chair, dresser and/or wardrobe
Room Style Double or Triple Rooms
Boys & GirlsAccommodated in separate residence houses and placed according to age
Supervision Counsellors live in residence houses with campers
Bed Linens Included & changed weekly
Pillows & Blankets Included
Towels Not provided
Laundry Service once weekly - included
Telephone All calls must be made using Skype® or personal phones
Internet / WiFi WiFi available - but use is limited (see policy below)
Toilets Shared common on residence floor (1:5 ratio)*
Showers Shared common on residence floor (1:5 ratio)*
MEALS3 meals daily + Snack Breakfast, Lunch, Dinner
• Evening snack included nightly• Nutritious and well-balanced meals served buffet-style in school dining hall
FACILITIES: • Classrooms - large, well equipped & air-conditioned• Dining Hall• Common rooms - air conditioned• Playing fields• Tennis courts• Basketball courts• Outdoor Running track• Waterfront area• Boathouse
LAKEFIELD CAMP INTERNATIONAL
• Gymnasium (indoor-only sport shoes required in gym)
• High and Low Ropes Course with Climbing Wall• Student recreation centre• Dance studio• Computer lab with internet• Infirmary with health care provider
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DAILY PROGRAMMING
MONDAY TO SATURDAY (excluding excursion days)
Morning 07:3008:00 - 08:4008:40 - 09:1009:15 - 10:1510:25 - 11:2511:35 - 12:35
Wake upBreakfastHouse clean-upPeriod 1 Period 2 Period 3
Afternoon 12:45 - 13:4513:45 - 14:4514:50 - 15:5016:00 - 17:0017:00 - 17:40
LunchRest PeriodPeriod 4Period 5REC Period
Evening 18:00 - 19:0019:00 - 20:3021:0021:30 - 22:00
22:00 - 23:00
DinnerEvening ProgrammeSnackAll students in rooms (by age)
Lights out (by age)
SUNDAYS Leisure Time & Theme day activities
Schedule may change on excursion days
PROGRAMME OPTIONS
Campers select their programme choice
at time of booking
ENGLISH PROFICIENCY recommended
CLASS
PERIODS per day
ACTIVITY
PERIODS per day
BEG PINT ADV out of 5 daily periods:
GENERAL ENGLISH
10 hours/week 2 3
15 hours/week 3 2
SPECIALTY
PROGRAMMES
English through Drama10 hours/week
2 3
Wilderness Education10 hours/week
2 3
ACTIVITY CAMP
Activities Only 5
LITLeader In Training(age 17 only)3 week programme
Customized Programme
(see details)
NOTES:
1. Students attending for 2 and 3 week sessions: only one programme choice possible
2. Students attending for 4 or 5 week sessions: more than one programme choice possible (minimum 2 weeks of each)
3. Programme switches are strongly discouraged as they are disruptive to the class dynamics. If a students wishes to change their programme
option while at camp, CISS requires written authorization from the student's natural parent(s) or guardian.
4. Programme changes, once approved, will only be made at the start of the week.
OR
OR
STRUCTURE: • All students taking English are tested on their first
Monday at the programme, and placed in a level-appropriate class
• Students are given a full orientation on their first day and all the rules about safety are carefully explained
• 5 x 1-hour periods + REC take place 5 days per week
• At the beginning of each week, students select their activities from a wide variety of water and land sports
• Students attend their chosen activities for one-week blocks, ensuring that they develop solid skills in those particular areas
• General English (10 or 15 hours), English through Drama or Wilderness Education comprise 2 or 3 periods daily
• On Sundays and on days when optional excursions are offered, the daily programme is modified to allow for group activities rather than the typical daily choices.
OR
OR
IMPORTANT!
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LAKEFIELD CAMP INTERNATIONAL
ESL- ENGLISH AS A SECOND LANGUAGE PROGRAMMEOur language classes follow a curriculum designed to aid foreign language learners to further their fluency and accuracy in English. With a focus on communication, lessons are designed for group oral activities as well as individual tasks in grammar, writing and reading.
10 HOURS PER WEEK 15 HOURS PER WEEK
• 2 periods daily • 10 hours of instruction per week• 1 hour = 60 minutes• 3 levels of ESL available (Beg/Int/Adv)• Small classes - max. 15 students, average 13 students
• 3 periods daily • 15 hours of total instruction per week• 1 hour = 60 minutes• 3 levels of ESL available (Beg/Int/Adv)• Small classes - max. 15 students, average 13 students
LANGUAGE INSTRUCTORS:• All ESL instructors have TESL certification or a teaching degree (B.Ed)• ESL instructors use modern communicative and task-oriented methodologies including group activities and role-
playing for effective language development
ENGLISH THROUGH DRAMA Drama is an excellent educational alternative to the ESL programme and is available for students of all English levels. Drama has been shown to increase confidence and enhance public speaking and pronunciation skills. The use and mastery of language through short rehearsed performances offers students new opportunities to improve fluency in a supportive and structured environment.
DRAMA INSTRUCTION
• 2 periods daily• 10 hours per week (2 week minimum participation)• 1 hour = 60 minutes• Experienced drama instructors• Small groups• Campers of ALL language proficiency levels accepted• Weekly modules with short performances at the end of each week
OR
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LAKEFIELD CAMP INTERNATIONAL
WILDERNESS EDUCATION PROGRAMME (WEP) The Wilderness Education programme is an excellent educational alternative to the ESL programme for students with an intermediate or high English proficiency. Lessons focus on sustainable environmental practices, native culture, wilderness exploration and discoveries unique to the local Canadian landscape. Lakefield has special access to a beautiful, typical Canadian landscape, which is the perfect setting for this increasingly popular and important study topic.
WEP INSTRUCTION COMPONENTS OF WEP
• 2 periods daily• 10 hours per week (2 week minimum participation)• 1 hour = 60 minutes• Experienced outdoor education instructors• Small groups• Weekly themed components• Daily journal recordings and Resource Book provided• Campers must have an intermediate or high
functioning English proficiency
1. Survival Skills: Shelter building, wilderness survival, campfire cooking, weather prediction
2. Camping Experience: Trip planning, mapping routes, dehydrating food, overnight camping
3. Native Canadian Studies: Learning about Native Canadians, their history, crafts, traditions and diet
4. Outdoor Skill Building: Canoeing, low and high ropes challenges, Compass and Map reading
5. Environmental Issues: Sustainable living, watershed management, study of local flora, fauna, and wildlife
ACTIVITY CAMP Students may choose Activity Camp, which means that they do not take any other programme options such as General English, English through Drama, or Wilderness Education. Activity Camp gives students an opportunity to use all five daily periods devoted to the activities of their choice.
ACTIVITY CAMP
• 5 periods daily• 25 hours per week• 1 hour = 60 minutes• Qualified and experienced instructors• All levels of English proficiency
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INSTRUCTED ACTIVITIES
DAILY INSTRUCTED ACTIVITIESALL CAMPERS have the opportunity to select and participate in general interest activities as follows:
Activity Camp: 5 instructed activity periods daily + REC period10 hours ESL, WEP or DRAMA: 3 instructed activity periods daily + REC period15 hours ESL: 2 instructed activity periods daily + REC period
Campers select their weekly activity choices from the list below. All activities are supervised and instructed in English. Each activity period lasts for 1 hour (60 minutes) daily.
ACTIVITY INSTRUCTORS• Activity instructors have proven competency skills in each of their activities• Lifeguards and activity instructors have certification in accordance with OCA (Ontario Camps Association) regulations
WATER ACTIVITIES SPORTS & ADVENTURE
• Canoeing • Sailing • Kayaking • SUP (Stand Up Paddleboard) • Swim Lessons • Windsurfing
• Archery • Mountain Biking• Basketball • Soccer• Beach Volleyball • Tennis• Canadian Sports
ARTS & MOVEMENT REC PERIOD ("REC")
• Arts & Crafts • Guitar (beginner)
• Dance • Theatre On regular camp days, 1 hour is allocated as a REC Period (REC). During REC, a variety of water and land sports & activities are offered, with the addition of the following specialized activities:
• Ropes & Climbing Wall
Campers have the opportunity to participate in different REC activities on a daily basis. All activities are supervised but not instructed.
HIGH ROPES / LOW ROPES / CLIMBING WALL
Professional instructors supervise and instruct campers in proper technique and safety. All students wear appropriate helmets and safety harnesses at all times.
LAKEFIELD CAMP INTERNATIONAL
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LAKEFIELD CAMP INTERNATIONAL
LEADER IN TRAINING (LIT) The Leader in Training (LIT) programme is focused on leadership development for youth aged 17 years old who hope to become future leaders either in a camp or similar educational setting. Participants acquire valuable leadership skills during specialized morning classes, designed to prepare them for their practical sessions. Afternoons offer hand-on experience, as they shadow experienced Lakefield staff during activity periods. LITs are mentored throughout the programme by senior staff.
LIT PROGRAMME STRUCTURE IN-CLASS LESSON COMPONENTS
The Leader in Training programme puts the concept of "leadership" into motion by providing participants with a combination of theoretical knowledge and practical hands-on experience in a camp environment. Morning lessons focus on examining theories, models, and types of leadership. LITs learn various techniques used by educators to lead and support younger children, including strategies for different scenarios that apply to a camp setting. Afternoons provide LITs with an opportunity to apply their new knowledge, as they assist camp staff in leading various camp activities and organizing different programmes. Participants are sure to leave the programme with new skills and experience that will serve them for a lifetime.
• 10 hours of specialized training classes per week• 1 hour = 60 minutes• 3 periods daily of supervised practical training while
learning to lead and teach activities• LITs work closely with an LIT Coordinator who supervises,
guides, and mentors the participants• First Aid Training included for all participants• Acceptance is pending full completion of a special
application, designed to assess English proficiency and relevant experience
• LITs must have a high functioning English proficiency as ESL is NOT a component of the programme
Morning lesson topics may include:• Camper safety and well-being• Crisis management• Time management skills• Organizing and planning activities• Working with children of different age groups• Conflict resolution• Creating positive team dynamics• Understanding different leadership styles• Effective communication within a team environment
PRACTICAL SKILL ACQUISITION
Afternoon practical programme components:• Assisting with activity instruction• Coaching children• Planning evening programmes• Self-reflection (Journal writing)
PROGRAMME OUTCOMES
Upon successful completion of the programme, participants can expect to receive:• First Aid Training• Leader in Training Completion Certificate• Performance Evaluation from LIT Coordinator
LIT PRACTICUM [NEW]
LITs who successfully complete their 3 week programme may extend their stay at Lakefield as part of the the LIT Practium. LITs have a chance to put their newly acquired skills to the test by assisting staff in a broader capacity. Participants may stay from 1-3 weeks.
NOTE: 1. LITs are expected to participate fully in the general Lakefield Camp programme when not involved in components of their LIT training. Attendance is mandatory at ALL functions and camp-wide activities.
DATES FOR SUMMER 2019
3 weeks: July 07 - July 27
NOTE: LIT candidate must enrol for entire session!
AGE 17
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EVENING PROGRAMMEThe evening programme is an opportunity for students and staff to do activities together. The programme is mandatory and is a combination of house-based activities and leisure options. Students from each residence house may team up to face each other in competition. Students may also enjoy camp-wide activities including the following:
• Banquets• Campfires • Camp Games• Cardboard boat races• Dances
• Overnight camping• Special interest groups• Sports Games• Talent Shows
Note: Some scheduled or optional full day excursions may run into the evening.
SCHEDULED EXCURSIONSFull Day: 1 every three weeks
• Toronto tour + shopping
Excursion is not guaranteed to participants enrolled for less than 3 weeks
OPTIONAL EXCURSIONS (not included)
Select optional excursions are offered to all campers at an extra fee. Excursions offered are dependent upon session dates and duration. All excursions are fully supervised by camp staff and include transportation, admission costs and meals as required.
Optional excursions may be paid for at camp or pre-paid to the representative prior to arrival at camp. Clients wishing to pre-pay for optional excursions must indicate this at time of booking. Otherwise, campers can choose to attend an optional excursion after they have arrived at the programme and money is automatically deducted from their student bank account accordingly.
Full Day OPTIONAL Cost:
• Canada’s Wonderland (Amusement Park) $80 CAD
• Disco Boat Cruise on Lake Ontario $65 CAD
• Niagara Falls (includes Hornblower boat tour) $120 CAD
• CN Tower (add-on to Toronto tour) $45 CAD
Note: Students who attend an optional excursion do not have activities or language instruction on that day. Leaders in Training have the option to
pay and participate in the optional excursions as "campers" or they can choose to attend free of charge, but will have supervised responsibilities as
part of their LIT course.
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LAKEFIELD CAMP INTERNATIONAL
QUALITY STAFFCISS is proud to have earned a reputation for recruiting motivated, caring and qualified personnel. Our commitment to providing an organized workplace and strong leadership has allowed us to attract seasonal employees that return year after year. Our hiring standards follow strict guidelines and adhere to the policies set forth by regulatory bodies such as the Ontario Camps Association. Our staff are trained in safety procedures, First Aid and childcare prior to the programme season and are prepared to manage all situations without compromise to the care and programming for other students.
SUPERVISION• CISS takes safety and supervision at our waterfront programme sites very seriously. Therefore, we provide an overall
staff to student ratio of approximately 1:5 at Lakefield Camp, providing excellent care and supervision of children• CISS staffing ratios ensure that staff are available to handle emergency situations (ie. take a student to see a doctor)
without compromising the supervision or instruction of other campers• Staff to camper ratios for all waterfront activities comply with standards set by the Ontario Camps Association,
providing a high level of water safety• CISS staff are available 24 hours, and live with students on the same residence floors, ensuring that an adult is always
available
• Staff conduct routine evening and night patrol
PARENT COMMUNICATION Unless it is an emergency, we ask that parents refrain from calling the camp directly. Campers are encouraged to call home upon arrival, and then once weekly. Below is a detailed description of the different ways in which campers may communicate with their parents.
CELL PHONE AND ELECTRONIC DEVICES: Campers who choose to bring a mobile device do so at their own risk, but will be limited to when they can use it (see below). Campers are not permitted to bring or use any devices during classes, meals or any activities. Devices are kept in the camp office or in another secure location and can only be signed out on designated days. CISS/Lakefield Camp is not responsible for lost, stolen, or damaged devices.
E-MAIL: There is WiFi on campus. Campers who need to communicate with their parents using an internet connection may do so ONLY on days when they are permitted to use their mobile or electronic device.
SKYPE®: Students who do not have a mobile device may call home using a pay phone or by using SKYPE through one of the computers on campus. Campers who do not already have a Skype® account may use the camp account, and are charged according to their usage time.
CISS CELL PHONE AND ELECTRONIC DEVICE POLICY:
The cell phone and electronic device policy at Lakefield Camp for 2019 will be as follows, without exception:
All camper devices are collected by programme staff upon arrival, during the check-in process. Devices are labeled and kept in a secured location. Campers are allowed to retrieve their devices twice per week. Once, on the evening prior to the scheduled Optional or Included Full-Day Excursion and again on the night before departures. Campers have use of their devices for a 24-hour period after which they must then return their devices to the programme staff, where they are stored again until the following week or until the camper departs.
During the time that campers have access to their devices, they must adhere to the following rules:
• Cell phone or electronic devices may be used during excursions, but within certain parameters• While on-campus, devices may only be used during specified time periods - campers may not talk on their cell
phone late at night or during group-based activities, where use of the device may be disruptive to others• All devices must be turned off at night so not to awaken other campers• CISS/Lakefield Camp is not responsible for devices that are lost, stolen or damaged
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LAKEFIELD CAMP INTERNATIONAL
PROGRAMME INCLUSIONS
Accommodation Double or triple rooms
Meals 3 daily, plus evening snack
Supervision
Study Materials
Sheets & Pillows
Blankets
Towels Must bring own
Laundry Once weekly service
Linen change Once weekly
English Hours(optional)
10 or 15 hrs per week
Wilderness Education(optional)
10 hrs per week
English through Drama(optional)
10 hrs per week
Full Day Excursion* 1 per 4-week session
Daily Activities Student-selected
Evening Programme Nightly
Sports Facilities
Airport Transfers Arrival & Departure
Medical Insurance $100,000 CAD
Emergency Dental Included in above
Healthcare Provider On campus
CISS T-Shirt Upon Arrival
Programme Certificate Upon Completion
* Shopping Excursion not guaranteed to participants enrolled for less than 3 weeks.
Students have time for shopping while on the optional excursion.
EXTRA EXPENSES
Optional Activities Admission + transportation costs
Extra Day stay* $200 CAD per night
Extra transfer fee $150 CAD If arriving/departing on non-scheduled day
Personal Spending $ -- at discretion for personal shopping
Early Morning Departure Fee
$150 CAD If flight is scheduled to depart before 08:00
Notarized Custodianship Fee
$100 CAD (if required)
CISS Unaccompanied Minor fee**
$100 CAD (if required)
* Students arriving early or departing late from the programme
will be charged extra day fees. Charges for extra days include
accommodation, meals, supervision, medical insurance and
programming as per the schedule.
** Students arriving and/or departing as Unaccompanied Minors must
register with their airline in advance and pay associated fees to the
airline directly. For all students registered as UM, CISS will charge an
additional fee.
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LAKEFIELD CAMP INTERNATIONAL
4 week SAMPLE calendar
SUNDAY MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY SATURDAY
Morning
Arrivals
Orientation, ESL
Testing
Activity Periods I-III
Activity Periods I-III Activity Periods I-IIICustomized Activity
Periods
OPTIONAL
EXCURSION:
Canada’s Wonderland
Activity Periods I-III Activity Periods I-III
AfternoonActivity Periods IV-V Activity Periods IV-V Activity Periods IV-V Activity Periods IV-V Activity Periods IV-V
REC Period REC Period REC Period REC Period REC Period
Evening House activityCamp Game
“Capture the Flag”
Camp Game
“Counsellor Auction"Campfire
Cardboard Boat
Races
Morning Arrivals / At leisure Activity Periods I-III Activity Periods I-III Activity Periods I-III
Customized Activity
Periods
OPTIONAL
EXCURSION:
Niagara Falls
Activity Periods I-III Activity Periods I-III
Afternoon Theme Day and
House Activities
Activity Periods IV-V Activity Periods IV-V Activity Periods IV-V Activity Periods IV-V Activity Periods IV-V
REC Period REC Period REC Period REC Period REC Period
Evening Sports House ActivityCamp Game
“Stones”Talent Show Dance Sports Games
Morning Arrivals / At leisure Activity Periods I-III Activity Periods I-III
FULL DAY
EXCURSION:
Toronto Tour +
Shopping
OPTIONAL:
CN Tower and/or
Disco Boat Cruise
Activity Periods I-III Activity Periods I-III Activity Periods I-III
AfternoonTheme Day and
House Activities
Activity Periods IV-V Activity Periods IV-V Activity Periods IV-V Activity Periods IV-V Activity Periods IV-V
REC Period REC Period REC Period REC Period REC Period
EveningCamp Game
“Phobias”House Activity
Camp Game
“Survival"
Cardboard Boat
RacesBanquet Theme Dance
Morning Arrivals / At leisure Activity Periods I-III Activity Periods I-III Activity Periods I-IIICustomized Activity
Periods
OPTIONAL
EXCURSION:
Niagara Falls or
Canada's Wonderland
Activity Periods I-III
AfternoonTheme Day and
House Activities
Activity Periods IV-V Activity Periods IV-V Activity Periods IV-V Activity Periods IV-VDepartures
REC Period REC Period REC Period REC Period
EveningCamp Game
“Stones”House Activity Hobby Night Talent Show Campfire
This schedule is a sample only. Finalized programme calendar to be published on the CISS website/Agent Zone
Notes:
1. Optional activities are listed in italics (extra fees apply).
2. Group requests may include Optional Activities at point of quotation.
SUMMER 2019 APPLICATION
1 of 3
PROGRAMME CHOICE 4 week sessions: 3 week sessions: 2 week sessions:
CITY
RES
IDEN
TIA
L
CISS Vancouver (YVR Gateway)
Arrivals: MondayDepartures: Monday
Global English (22hrs) July 01 - July 29July 08 - Aug 05July 15 - Aug 12
July 01 - July 22July 08 - July 29July 15 - Aug 05July 22 - Aug 12
July 01 - July 15July 08 - July 22July 15 - July 29July 22 - Aug 05July 29 - Aug 12
CISS at Trinity (YYZ Gateway)
Arrivals: SundayDepartures: Saturday
General English (20 + 5 Practical Hrs)
Academic & Career Prep (25hrs)*June 30 - July 20 or July 21 - Aug 10
June 30 - July 27July 07 - Aug 03July 14 - Aug 10July 21 - Aug 17
June 30 - July 20*July 07 - July 27July 14 - Aug 03July 21 - Aug 10*July 28 - Aug 17
June 30 - July 13July 07 - July 20July 14 - July 27July 21 - Aug 03July 28 - Aug 10Aug 04 - Aug 17CISS St. Michael’s
(YYZ Gateway)
Arrivals: SundayDepartures: Saturday
General English (20 Hrs)
Global Leadership (20 Hrs)*June 30 - July 20 or July 21 - Aug 10
SUM
MER
CA
MPS
Lakefield Camp (YYZ Gateway)
Arrivals: SundayDepartures: Saturday
Optional Activities & LIT Practicum
10 Hrs General English 15 Hrs General English Activity Camp English through DramaWilderness Education Programme (WEP)Leader in Training (LIT)*July 07-27
June 30 - July 27 July 07 - Aug 03 July 14 - Aug 10 July 21 - Aug 17
June 30 - July 20July 07 - July 27*July 14 - Aug 03July 21 - Aug 10July 28 - Aug 17
June 30 - July 13July 07 - July 20July 14 - July 27July 21 - Aug 03July 28 - Aug 10Aug 04 - Aug 17
Niagara Falls (July 11 & 25, Aug 01 & 15)
Disco Boat Cruise (July 17)
Canada’s Wonderland (July 04 & 25, Aug 01)
CN Tower (July 17 & Aug 08)
LIT Practicum: 1 week (July 28 - Aug 03)2 weeks (July 28 - Aug 10)3 weeks (July 28 - Aug 17)
Swallowdale Camp (YYZ Gateway)
Arrivals: SundayDepartures: Saturday
Optional Activities & LIT Practicum
10 Hrs General English Activity Camp Leader in Training (LIT) *July 07-27
June 30 - July 27 July 07 - Aug 03
July 14 - Aug 10
June 30 - July 20 July 07 - July 27* July 14 - Aug 03 July 21 - Aug 10
June 30 - July 13 July 07 - July 20 July 14 - July 27 July 21 - Aug 03 July 28 - Aug 10
Niagara Falls (July 03, 17, 31)
Canada’s Wonderland (July 10 & 24, Aug 07)
LIT Practicum: 1 week (July 28 - Aug 03) 2 weeks (July 28 - Aug 10)
NO
TES • LIT (Leader in Training), Global Leadership or Academic & Career Prep programme require a separate application form that must be
completed to assess English and aptitude levels for the programme. • Optional activities and LIT Practicum add-on weeks are an additional cost. Please refer to the CISS MLI Price List for further information or
contact your agent or CISS MLI representative.
Application Date:
2019 PROGRAMME SELECTION
First Name:
Last Name:
Address:
City: Province / State:
Country: Postal Code:
Home Tel: Student Mobile:
Birth Date (MM/DD/YY): Age at camp:
Male Female Nationality:
Agency (if applicable):
Passport #: Expiry Date:
STUDENT/CAMPER INFORMATION
Parent #1 - Name: Last Name:
Mobile Tel: Email:
Parent #2 - Name: Last Name:
Mobile Tel: Email:
Parents are: Married Divorced Common-Law Widowed
Student Lives with: Parent #1 Parent #2 Other:
If divorced, who has legal custody? Parent #1 Parent #2 Other
Does non-custodial parent have visiting rights? Yes No
Emergency Contact - Name: Last Name:
Mobile Tel: Relation to child:
PARENT/GUARDIAN INFORMATION
STUDENT: DATE:
2 of 3
ALLERGIES: Please list all allergies (food, environmental, medical), associated reactions and medications:Allergy Reaction Life-Threatening?* Medication
Yes No
Yes No
Yes No
Yes No *Life-Threatening allergies are allergies that can cause severe and immediate harm to a student and could quickly result in death if not treated with emergency medical care or a life-saving injection (ie. Epi-Pen).
If allergy is life-threatening... 1. Does the student carry an Epi-Pen or similar injector? Yes No 2. Is the student aware of how to use it and capable of using it him/herself? Yes No
MEDICATION: Please list any medication(s) that the student should NOT take?
For mild headaches or mild pain, student can receive: Acetaminophen (Tylenol) Ibuprofen (Advil) Other:
Does the student take medication on a regular basis? If yes, please list:
- Will the student be bringing this medication to Canada? Yes* No
- Does this medication require injections? Yes** No* Medication carried by students will be administered ONLY IF contents and instructions are properly labelled in English.** CISS staff cannot administer needle injections to students except in the event of a life-threatening situation (i.e. Epi-Pen). Students who require injections must arrive at programme prepared to administer the injections themselves, under the supervision of programme staff.
Please list any major illnesses or surgeries the student has had in the past 5 years.
DIETARY: Is the student... Vegetarian Vegan Gluten-Free Lactose-Free Other
IMMUNIZATIONS: Please list the date of the last immunization for each of the following:
Varicella (Chicken Pox): Has the student had chicken pox? Yes No Tetanus:
GENERAL WELL-BEING:
Overall, the student’s general health is: Excellent Good Poor (please explain):
Has the student suffered from, or is the student being treated for any mental/nervous disorder - including, but not limited to, Anxiety, Depression, Attention
Deficit Disorder (ADD), Anorexia? No Yes (please xplain):
Has the student experienced any emotional trauma that may affect his/her behaviour while at our CISS programme (ie. recent death in family, divorce, accident)? No Yes (please xplain):
Student wears prescription glasses/contacts: Yes No Dental braces: Yes No Hearing Aid: Yes No
Student is... Diabetic Epileptic Student can swim? Yes No
Student has issues with: Nightmares Bed-wetting Homesickness Sleepwalking
Please list any activities in which the student should NOT participate in:
Is there anything else we should know about your child?
ROOMING: My child would like to share a room with - Choice #1: Choice #2:*Requests will be considered but cannot be guaranteed.
Additional Notes:
HEALTH/MEDICAL INFORMATION
EXTRA FEES1. In addition to included activities and excursions, CISS MLI programmes also offer some optional excursions. These are provided to students at minimal cost and presented upon arrival at camp (CISS St. Michael’s, CISS at Trinity & CISS Vancouver) or at the time of registration (Lakefield & Swallowdale). Payment is made by the student/parent at time of selection. For city residential programmes, costs are determined and may vary depending on the number of participants.2. If a student requires a Visa, a Notarized Custodianship Fee of $100 CAD per student may apply. 3. Extra Day Fees include: accommodation, meals, supervision, medical insurance and programming as per the schedule - additional lessons are not included. 4. Leader in Training (LIT) Practicum option is an additional cost and is offered to students at the time of registration. Please refer to the CISS MLI Price List for further information or contact your agent, or CISS MLI representative.
TRANSFER NOTES 1. Airport arrival and departure transfers between the gateway airport and programme site are included for students arriving and departing on scheduled dates. Students travelling on non-scheduled arrival or departure dates may incur extra fees.2. If a student is travelling as an Unaccompanied Minor (UM), a one-time fee of $75 CAD per student will apply. 3. Early Morning Departure Fees apply to all students with flights scheduled to depart before 08:00.
CONDITIONS & POLICIES1. CISS MLI will not accept responsibility for money lost or stolen. Similarly, CISS MLI will not be responsible for damage, loss or theft of any student’s personal belongings, including clothing collected for laundry. Students are encouraged not to bring valuables. 2 . The camper and his/her parents/guardian understand that all rules of the programme must be followed. Failure to abide by the rules and policies of the programme may result in dismissal. There will be no refunds paid if the participant is dismissed.3. CISS MLI and its staff take photographs and video content during the camp sessions to be used for promotional purposes including, but not limited to: website, programme brochures, advertisements and for use by CISS MLI agents to promote this programme internationally. Except in cases of testimonials used on our website, social media or in brochures, camper names are not typically used in connection with the photograph(s). If you wish for your child to not be photographed, please let your agent or a CISS MLI representative know in advance. 4. Leader in Training (LIT), Global Leadership or Academic & Career Prep programme require a separate application form that must be completed to assess English and aptitude level for the programme. HEALTH & MEDICAL - PARENT / GUARDIAN AGREEMENTTo the best of my knowledge, my child is in good health and has not been exposed to any infectious disease in the past four weeks. In case of surgical emergency, should we not be immediately available for consultation, I hereby give permission to the physician selected by the Camp Director to hospitalize, secure proper treatment for, and to order injections, anesthetics or surgery for my child as named above.
I hereby agree that the relationship and the resolution of any and all disputes arising therefrom between myself and health services provided through CISS MLI shall be governed by and construed in accordance with the laws of the Province in which the programme operates. I hereby acknowledge that the treatment will be performed in the Province in which the programme operates and that the courts of the Province in which the programme operates shall have jurisdiction to entertain any complaint, demand, claim or cause of action whether based on alleged breach of contract or alleged negligence arising out of the treatment. I hereby agree that if I commence any such legal proceedings they will be only in the Province in which the programme operates and hereby irrevocably submit to the exclusive jurisdiction of the Courts of the Province in which the programme operates.
I hereby waive, release and absolve and agree to indemnify and save harmless CISS MLI and their respective officers, employees and agents from all liability arising from my child’s participation in their programme, except such as results solely from its or their willful neglect or willful default.
Medication carried by students will not be administered if contents and instructions are not properly labelled in English. Students who require daily injections must arrive at camp prepared to administer the injections themselves, under the supervision of CISS MLI staff. CISS MLI health care providers are not permitted to administer injections except in the event of an emergency (i.e. Epi-Pen).
It is the responsibility of the parent/guardian to inform CISS MLI if there are any changes in the child’s medical condition after this form has been submitted to CISS MLI.
I confirm that my child is capable of participating safely in the full programme and all activities unless I otherwise advise CISS MLI in writing. I acknowledge that such participation involves risks and hazards incidental thereto all of which are assumed by me. I agree to be responsible for any extra expenses incurred by my child or by CISS MLI on behalf of my child.
I have read, understand and accept the conditions and policies on this form.
Parent/Guardian Signature: Date:
STUDENT: DATE:
PROGRAMME POLICIES
3 of 3
payment form
ST. MICHAEL’S City Residential LAKEFIELD CAMP International
transfers arranged only to/from
Pearson International Airport (YYZ)
I would like to pay the total owing by credit card: Visa Mastercard American Express
Credit Card Number Expiry Date /
Name of Cardholder Signature
I would like to pay the total owing by bank wire/transfer:
Canadian $ payments:
Canadian International Student Services
439 University Ave, Suite 2110
Toronto, Ontario, CANADA M5G 1Y8
Tel: +1 (416) 646-5400
Fax: +1 (416) 646-5403
TD Canada Trust Bank
2 St. Clair Avenue East
Toronto, Ontario, CANADA M4T 2V4
Swift code: TDOMCATTTOR
Transit #: 19682
Account #: 0617-5275714
*Notes:
1. Extra day prices include: accommodation, meals, supervision, medical insurance and programming as scheduled.
3. Special transfer fees apply ONLY when student arrives or departs on a non-scheduled arrival or departure day as per our session listing, and
requires CISS to arrange a special transfer. There are no additional transfer fees when arriving/departing on scheduled arrival or departure days.
4. Payment details must include the student’s name. Please ensure that all bank / service charges are paid as CISS will not be responsible for assuming these fees.
I authorize CISS (Canadian International Student Services Inc.) to perform the following transactions.
These charges represent payment for the above mentioned programme for my son/daughter.
*please note that a service charge of 3% CAD will be charged on payments made by credit card.
Please ensure student’s name is indicated on transfer form, and payment of all service fees is arranged by you. Payment to be made by bank transfer, international money order or bank draft to:
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EDIT
CA
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Clear Form
SUMMER
4 weeks: 3 weeks:
2 weeks:
Student NAME:
Please select the session for which the student is registered:
ADDITIONAL FEES Extra Day St. Michael’s >>> Indicate specific dates:
Lakefield Camp >>> Indicate specific dates:
be scheduled between 11:00 - 19:00) Lakefield
Extra Transfers St. Michael’s
(Apply only if an extra day is required. Arrival
and departure times for extra transfers must
Recommended