Primary BC Jamatkhana *
- Select - Abbotsford / Chilliwack Burnaby Lake Darkhana Downtown Vancouver Fraser Valley Headquarters - Vancouver Kelowna / Penticton Nanaimo Richmond SFU Tri-City UBC University of Victoria Victoria
Primary Edmonton Jamatkhana *
- Select - Belle Rive Edmonton West Fort McMurray Headquarters - Edmonton Red Deer University of Alberta
Primary Prairies Jamatkhana *
- Select - Calgary Northwest Calgary South Franklin Headquarters - Calgary Lethbridge Regina Saskatoon Waterton Park Westwinds Winnipeg University of Calgary
Primary Ontario Jamatkhana *
- Select - Barrie Belleville Bobcaygeon Brampton Brantford Don Mills Downtown Toronto Dundas West East York Etobicoke Guelph Halton Hamilton Headquarters - Ismaili Centre, Toronto Kitchener London Meadowvale Mississauga Niagara Falls Oshawa Pickering Richmond Hill Scarborough St. Thomas Sudbury Tillsonburg Unionville Willowdale Windsor University of Guelph McMaster University Queen's University Ryerson University University of Toronto (Scarborough) University of Toronto (St. George) University of Waterloo University of Western Ontario University of Windsor Wilfrid Laurier University York University
Primary Ottawa Jamatkhana *
- Select - Headquarters - Ottawa Kingston Carleton University University of Ottawa
Primary Quebec Jamatkhana *
- Select - Brossard Cure Labelle Granby Halifax Headquarters - Montreal Laval McGill University Quebec City Sherbrooke St. Johns
Participant #1 Information
Participant #1 First Name *
Participant #1 Middle Name
Participant #1 Last Name *
Participant #1 Gender *
Participant #1 Email Address *
Participant #1 Phone Number *
Phone Number Type *
- Select - Cell Home Work
Participant #1 Mailing Address
Participant #1 Education
Participant #1 Technology
Participant #1 Questions
What is your greatest passion? Explain how you spend your time participating in this activity. *
Please list any volunteer and/or leadership experiences you have had *
Do you have any physical needs that would limit your ability to participate fully in such a program? If yes, please explain how best we can support you: *
Participant #1 Special Considerations
At Camp Odyssey, we want to support mental resilience. Have you recently experienced a situation that may affect your mental or emotional well-being during the program? This might include regular sadness or depression, a recent death or tragedy in the family, victim of bullying, loneliness, anxiety, high levels of stress, etc. If yes, please explain how best we can support you:
At Camp Odyssey, we want every participant to feel supported. Do you currently receive any academic support or accommodations (for example, support for learning disabilities, ongoing counseling, etc.)? If yes, please explain how best we can support you, and include details about how other supportive individuals, are helping meet your needs:
At Camp Odyssey, we want to ensure the safety of all participants and staff. Have you ever been involved in incidents of physical or verbal abuse, or violating any laws, etc.? If yes, what were the circumstances and how was the incident resolved/what was the outcome?
Participant #1 Summer Program
Participant #2 Information
Participant #2 First Name *
Participant #2 Middle Name
Participant #2 Last Name *
Participant #2 Gender *
Participant #2 Email Address *
Participant #2 Phone Number *
Phone Number Type *
- Select - Cell Home Work
Participant #2 Mailing Address
Participant #2 Education
Participant #2 Technology
Participant #2 Questions
What is your greatest passion? Explain how you spend your time participating in this activity. *
Please list any volunteer and/or leadership experiences you have had *
Do you have any physical needs that would limit your ability to participate fully in such a program? If yes, please explain how best we can support you: *
Participant #2 Special Considerations
At Camp Odyssey, we want to support mental resilience. Have you recently experienced a situation that may affect your mental or emotional well-being during the program? This might include regular sadness or depression, a recent death or tragedy in the family, victim of bullying, loneliness, anxiety, high levels of stress, etc. If yes, please explain how best we can support you:
At Camp Odyssey, we want every participant to feel supported. Do you currently receive any academic support or accommodations (for example, support for learning disabilities, ongoing counseling, etc.)? If yes, please explain how best we can support you, and include details about how other supportive individuals, are helping meet your needs:
At Camp Odyssey, we want to ensure the safety of all participants and staff. Have you ever been involved in incidents of physical or verbal abuse, or violating any laws, etc.? If yes, what were the circumstances and how was the incident resolved/what was the outcome?
Participant #2 Summer Program
Parent/ Caregiver #1 Information
Parent/ Caregiver #2 Information
Consent and Waiver
Release and Waiver of Liability
I fully and forever release, discharge and indemnify His Highness Prince Aga Khan Shia Imami Ismaili Council for Canada, all local Councils, boards and portfolios, volunteers, employees, contractors, representatives, committees, associations, appointed officials, successors, assigns, sponsors of the Program, together with all Program directors, volunteers, staff, coaches, partners, training and medical personnel (collectively, the “Released Parties ”) jointly and severally, of and from any and all causes of action, lawsuits, losses, damages, injuries, howsoever occurring, whether by negligence or otherwise (including death), claims, demands, sums, costs, expenses (including legal fees and disbursements), and any other liability of any kind, of or to me or any other person, directly or indirectly arising out of or in connection with my participation in and attendance at the Program.
I AGREE NOT TO initiate any lawsuit, court action or other legal proceeding against the Released Parties, nor join or assist in the prosecution of any claim for money damages which anyone may have, on account of loss, damage, or injury sustained by me or others, howsoever occurring, whether by negligence or otherwise , in connection with my selection of, participation in and attendance at the Program or transportation connected thereto, and I waive any right I may have to do so. This means that I cannot sue to hold the Released Parties responsible for any loss, damage, or injury that I may experience related to the Program.
Authority and Capacity
I have the capacity and legal authority to sign the consents, waivers and releases above and I have read and understood the terms above. The parents/guardians of the Participant(s), by their electronic signature below, also agree to the foregoing on behalf of themselves and of the Participant(s).
Electronic signature of parent or guardian (please type name) *
Participant #1 to which this waiver/consent/release applies (please type name) *
Participant #2 to which this waiver/consent/release applies (please type name) *
Submit
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