Youth Program

Youth Camp

Camp Arbuckle · June 27–30, 2026

Dates

June 27–30

Location

Camp Arbuckle

Age Group

Youth (15+)

Participant Information

First Name *

Last Name *

Date of Birth *

Home Address *

School *

Phone *

Email *

Medical Conditions / Allergies *

Dietary Restrictions

Parent / Guardian Information

Guardian First Name *

Guardian Last Name *

Guardian Phone *

Guardian Email *

Additional Information

How did you hear about this program? *

Consent & Permissions

Image Release *

Do you permit the use of photos and videos taken of the group's activities that include your son/daughter to be used in the program's promotional materials (e.g. brochures, Instagram)?

YesNo

I hereby give permission for my son/daughter to attend this summer program. I understand that the Junior Youth Empowerment Program will endeavor to provide my son/daughter with a safe environment. In the case of personal injury, loss or damage I, or a third party, will not hold Junior Youth Empowerment Program, its agents or volunteers responsible.

Yes, I agree to the above *

Questions? community@kelownayouth.ca