Please select the week of your family's participation to the camp
Children's information Register a child that has received a diagnosis?(Required) Name
First name
Last name
Is your child currently undergoing treatments?(Required) Does your child have a central intravenous catheter? If so, what type of catheter? Other documents to submit
Vaccines Has your child received a tetanus vaccine since 2014? Has your child received the chicken pox vaccine? Has your child had chicken pox?
General Health Please check the conditions or health problems that apply to your child. If you ticked one of the boxes above, please specify the type of health problem or condition.
Does your child use a walking aid (crutch, wheelchair, cane, other aid)? Does your child need help with activities of daily living? Does this participant have any allergies or intolerances? Is an Epipen needed? Diet and food preferences: check if applicable. Does your child need to take medication during camp? If so, we will send you a document to fill out. Leucan takes care of administrating medication for every child during camp.
Let us know of any peculiarities, habits or ways of being that might help us to better know, understand and work with your child to get the most out of camp:
Register a sibling?(Required) Name
First name
Last name
Vaccines Has your child received a tetanus vaccine since 2014? Has your child received the chicken pox vaccine? Has your child had chicken pox?
General Health Please check the conditions or health problems that apply to your child. If you ticked one of the boxes above, please specify the type of health problem or condition.
Does your child use a walking aid (crutch, wheelchair, cane, other aid)? Does your child need help with activities of daily living? Does this participant have any allergies or intolerances? Is an Epipen needed? Diet and food preferences: check if applicable. Does your child need to take any medication during camp? If so, we will send you a document to fill out. Leucan takes care of administrating medication for every child during camp.
Let us know of any peculiarities, habits or ways of being that might help us to better know, understand and work with your child to get the most out of camp:
Register another sibling? 1(Required) Name
First name
Last name
Vaccines Has your child received a tetanus vaccine since 2014? Has your child received the chicken pox vaccine? Has your child had chicken pox?
General Health Please check the conditions or health problems that apply to your child. If you ticked one of the boxes above, please specify the type of health problem or condition.
Does your child use a walking aid (crutch, wheelchair, cane, other aid)? Does your child need help with activities of daily living? Does this participant have any allergies or intolerances? Is an Epipen needed? Diet and food preferences: check if applicable. Does your child need to take any medication during camp? If so, we will send you a document to fill out. Leucan takes care of administrating medication for every child during camp.
Let us know of any peculiarities, habits or ways of being that might help us to better know, understand and work with your child to get the most out of camp:
Register another sibling? 2(Required) Name
First name
Last name
Vaccines Has your child received a tetanus vaccine since 2014? Has your child received the chicken pox vaccine? Has your child had chicken pox?
General Health Please check the conditions or health problems that apply to your child. If you ticked one of the boxes above, please specify the type of health problem or condition.
Does your child use a walking aid (crutch, wheelchair, cane, other aid)? Does your child need help with activities of daily living? Does this participant have any allergies or intolerances? Epipen necessary? Diet and food preferences: check if applicable. Does your child need to take any medication during camp? If so, we will send you a document to fill out. Leucan takes care of administrating medication for every child during camp.
Let us know of any peculiarities, habits or ways of being that might help us to better know, understand and work with your child to get the most out of camp:
Register another sibling? 3(Required) Name
First name
Last name
Vaccines Has your child received a tetanus vaccine since 2014? Has your child received the chicken pox vaccine? Has your child had chicken pox?
General Health Please check the conditions or health problems that apply to your child. If you ticked one of the boxes above, please specify the type of health problem or condition.
Does your child use a walking aid (crutch, wheelchair, cane, other aid)? Does your child need help with activities of daily living? Does this participant have any allergies or intolerances? Epipen necessary? Diet and food preferences: check if applicable. Does your child need to take any medication during camp? If so, we will send you a document to fill out. Leucan takes care of administrating medication for every child during camp.
Let us know of any peculiarities, habits or ways of being that might help us to better know, understand and work with your child to get the most out of camp:
Register another sibling? 4(Required) Nom
First name
Last name
Vaccines Has your child received a tetanus vaccine since 2014? Has your child received the chicken pox vaccine? Has your child received the chicken pox vaccine?
General Health Please check the conditions or health problems that apply to your child. If you ticked one of the boxes above, please specify the type of health problem or condition.
Does your child use a walking aid (crutch, wheelchair, cane, other aid)? Does your child need help with activities of daily living? Does this participant have any allergies or intolerances? Epipen necessary? Diet and food preferences: check if applicable. Does your child need to take any medication during camp? If so, we will send you a document to fill out. Leucan takes care of administrating medication for every child during camp.
Let us know of any peculiarities, habits or ways of being that might help us to better know, understand and work with your child to get the most out of camp:
Register a parent?(Required) Name
First name
Last name
Please check the conditions or health problems that apply to this participant. If you ticked one of the boxes above, please specify the type of health problem or condition.
Does this participant require a walking aid (crutch, wheelchair, cane, other aid)? Does this participant suffer from any allergies or intolerances? Epipen necessary? Diet and food preferences: check if applicable.
Add another parent?(Required) Name
First name
Last name
Please check the conditions or health problems that apply to this participant. If you ticked one of the boxes above, please specify the type of health problem or condition.
Does this participant require a walking aid (crutch, wheelchair, cane, other aid)? Does this participant suffer from any allergies or intolerances? Epipen necessary? Diet and food preferences: check if applicable.
Overall health(Required) I understand that it is essential to notify Leucan of any infectious manifestations that may occur within 2 weeks of the camp (fever, flu-like symptoms, gastrointestinal symptoms, cold sores, rashes, etc.).
Consent form for participants over 14 years old Add a consent form for a person aged 14 and over?(Required) Participating parents must complete a consent form as well.
I authorize the use of photos and videos taken of myself during the activity to represent Leucan's mission. I authorize that my name, images, voice and comments be used without limit of territory, media or language to promote Leucan's mission for a period of one year. Consent I agree to respect all instructions and guidelines of the activity organized by Leucan.
Consent I acknowledge that my participation in the activity may involve risks, and I hereby assume and freely accept all risks arising from my participation in this activity. I acknowledge and accept that Leucan declines all responsibility for the risks that my participation in the activity may entail and that Leucan cannot be held responsible for any damages of any kind (physical, moral or material) that I may suffer in connection with my participation in this activity. Therefore, I agree to release and hold harmless Leucan, the event organizers, volunteers, sponsors, partners and their respective employees and agents present at this activity from any and all liability for loss, damage or injury to myself as a participant or to my property that may arise or occur in connection with my participation in this activity, and I waive all rights with respect to the foregoing.
I, the undersigned, (name of the participant), accept the terms and conditions of this activity.
First name
Last name
Add a consent form for another person aged 14 and over?(Required) I authorize the use of photos and videos taken of myself during the activity to represent Leucan's mission. I authorize that my name, images, voice and comments be used without limit of territory, media or language to promote Leucan's mission for a period of one year. Consent I agree to respect all instructions and guidelines of the activity organized by Leucan.
Consent I acknowledge that my participation in the activity may involve risks, and I hereby assume and freely accept all risks arising from my participation in this activity. I acknowledge and accept that Leucan declines all responsibility for the risks that my participation in the activity may entail and that Leucan cannot be held responsible for any damages of any kind (physical, moral or material) that I may suffer in connection with my participation in this activity. Therefore, I agree to release and hold harmless Leucan, the event organizers, volunteers, sponsors, partners and their respective employees and agents present at this activity from any and all liability for loss, damage or injury to myself as a participant or to my property that may arise or occur in connection with my participation in this activity, and I waive all rights with respect to the foregoing.
I, the undersigned, (name of the participant), accept the terms and conditions of this activity.
First name
Last name
Add a consent form for another person aged 14 and over?(Required) I authorize the use of photos and videos taken of myself during the activity to represent Leucan's mission. I authorize that my name, images, voice and comments be used without limit of territory, media or language to promote Leucan's mission for a period of one year. Consent I agree to respect all instructions and guidelines of the activity organized by Leucan.
Consent I acknowledge that my participation in the activity may involve risks, and I hereby assume and freely accept all risks arising from my participation in this activity. I acknowledge and accept that Leucan declines all responsibility for the risks that my participation in the activity may entail and that Leucan cannot be held responsible for any damages of any kind (physical, moral or material) that I may suffer in connection with my participation in this activity. Therefore, I agree to release and hold harmless Leucan, the event organizers, volunteers, sponsors, partners and their respective employees and agents present at this activity from any and all liability for loss, damage or injury to myself as a participant or to my property that may arise or occur in connection with my participation in this activity, and I waive all rights with respect to the foregoing.
I, the undersigned, (name of the participant), accept the terms and conditions of this activity.
First name
Last name
Add a consent form for another person aged 14 and over?(Required) I authorize the use of photos and videos taken of myself during the activity to represent Leucan's mission. I authorize that my name, images, voice and comments be used without limit of territory, media or language to promote Leucan's mission for a period of one year. Consent I agree to respect all instructions and guidelines of the activity organized by Leucan.
Consent I acknowledge that my participation in the activity may involve risks, and I hereby assume and freely accept all risks arising from my participation in this activity. I acknowledge and accept that Leucan declines all responsibility for the risks that my participation in the activity may entail and that Leucan cannot be held responsible for any damages of any kind (physical, moral or material) that I may suffer in connection with my participation in this activity. Therefore, I agree to release and hold harmless Leucan, the event organizers, volunteers, sponsors, partners and their respective employees and agents present at this activity from any and all liability for loss, damage or injury to myself as a participant or to my property that may arise or occur in connection with my participation in this activity, and I waive all rights with respect to the foregoing.
I, the undersigned, (name of the participant), accept the terms and conditions of this activity.
First name
Last name
Add a consent form for another person aged 14 and over?(Required) I authorize the use of photos and videos taken of myself during the activity to represent Leucan's mission. I authorize that my name, images, voice and comments be used without limit of territory, media or language to promote Leucan's mission for a period of one year. Consent I agree to respect all instructions and guidelines of the activity organized by Leucan.
Consent I acknowledge that my participation in the activity may involve risks, and I hereby assume and freely accept all risks arising from my participation in this activity. I acknowledge and accept that Leucan declines all responsibility for the risks that my participation in the activity may entail and that Leucan cannot be held responsible for any damages of any kind (physical, moral or material) that I may suffer in connection with my participation in this activity. Therefore, I agree to release and hold harmless Leucan, the event organizers, volunteers, sponsors, partners and their respective employees and agents present at this activity from any and all liability for loss, damage or injury to myself as a participant or to my property that may arise or occur in connection with my participation in this activity, and I waive all rights with respect to the foregoing.
I, the undersigned, (name of the participant), accept the terms and conditions of this activity.
First name
Last name
Add a consent form for another person aged 14 and over?(Required) I authorize the use of photos and videos taken of myself during the activity to represent Leucan's mission. I authorize that my name, images, voice and comments be used without limit of territory, media or language to promote Leucan's mission for a period of one year. Consent I agree to respect all instructions and guidelines of the activity organized by Leucan.
Consent I acknowledge that my participation in the activity may involve risks, and I hereby assume and freely accept all risks arising from my participation in this activity. I acknowledge and accept that Leucan declines all responsibility for the risks that my participation in the activity may entail and that Leucan cannot be held responsible for any damages of any kind (physical, moral or material) that I may suffer in connection with my participation in this activity. Therefore, I agree to release and hold harmless Leucan, the event organizers, volunteers, sponsors, partners and their respective employees and agents present at this activity from any and all liability for loss, damage or injury to myself as a participant or to my property that may arise or occur in connection with my participation in this activity, and I waive all rights with respect to the foregoing.
I, the undersigned, (name of the participant), accept the terms and conditions of this activity.
First name
Last name
Consent form for children under 14 years old Add a consent form for one or multiple participants under 14 years old?(Required) I authorize that photos and videos taken of my child during the activity be used to represent Leucan's mission. I authorize that my child's name, images, voice and comments be used without limit of territory, media or language to promote Leucan's mission for a period of one year. Consent I agree to respect all instructions and guidelines of the activity organized by Leucan.
Consent I acknowledge that my child’s participation in the activity may involve risks, and I hereby assume and freely accept all risks arising from their participation in this activity. I acknowledge and accept that Leucan declines all responsibility for the risks that my child’s participation in the activity may entail and that Leucan cannot be held responsible for any damages of any kind (physical, moral or material) that my child may suffer in connection with their participation in this activity. Therefore, I agree to release and hold harmless Leucan, the event organizers, volunteers, sponsors, partners and their respective employees and agents present at this activity from any and all liability for loss, damage or injury to my child as a participant or to my child’s property that may arise or occur in connection with their participation in this activity, and I waive all rights with respect to the foregoing.
I, the undersigned, (name of the parent/legal guardian), authorizes the children mentionned above to participate in this activity and accept the terms and conditions of this activity.
First name
Last name
