Play Days at Newton's Grove School

Play Days Registration

Play Days

Play Days Selection
Student/Parent/Guardian Information
Release of Liability / Waiver of Claims
Payment

Select Play Days

Nov 07, 2025 - November Play Day

Jan 05, 2026 - January Play Day

Feb 17, 2026 - February Play Day

Jun 12, 2026 - June Play Day

Total

All Play Days

Price: $280.00

Selected Play Days

Price: $

Payment Method

Online via Credit Card

e-Transfer / Cheque / Cash

Processing Fee

Price: $

No payment items has been selected yet

For payments via e-Transfer, please send the full amount () to jmathura@newtonsgroveschool.com and include the student name, parent/guardian name, and email address.

NO REFUNDS. ALL REGISTRATIONS ARE FINAL.

Student Information

First Name

Last Name

Date of Birth (DD/MM/YYYY)

Please indicate whether the student is a Newton’s Grove Student

Yes

Grade level as of September 2025

Health Card Number

Address

Address Line 1

Address Line 2

City

Postal Code

Drug Allergies

Medications

Parent/Guardian Information

First Name

Last Name

Email Address

Phone Number

Is the Parent/Guardian also the Emergency Contact?

Yes

Emergency Contact Information

First Name

Last Name

Email Address

Phone Number

Release of Liability / Waiver of Claims

Read and review the Release of Liability/Waiver of Claims agreement carefully then sign and date it below.

In consideration of being allowed to participate in any or all of the services and activities, the undersigned acknowledges, appreciates, and agrees that: (1) Participation includes possible exposure to and illness from infectious diseases including but not limited to MRSA, influenza, and COVID-19. While particular rules and personal discipline may reduce this risk, the risk of serious illness and death does exist; and, (2) Participant for myself, and/or on behalf of my minor child(ren)/ward(s) KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RELEASEES or others, and assume full responsibility for my participation; and, (3) agree to comply with the stated and customary terms and conditions for participation with respect to protection against infectious diseases and if I observe any unusual or significant hazard during my presence or participation, I will remove myself from participation and bring such to the attention of the nearest management employee immediately; and (4) that I, as parent/guardian, with legal responsibility for any minor participant, have read and explained the provisions in this waiver/release to my child/ward including the risks of presence and participation and his/her personal responsibilities for adhering to the rules and regulations for protection against infectious diseases; and, (5) I, for myself and/or on behalf of my spouse, and minor child(ren)/ward(s) as well as on behalf of my heirs, assigns, personal representatives and next of kin, HEREBY RELEASE AND HOLD HARMLESS Newton’s Grove School, its officers, officials, agents, and/or employees, other participants, sponsoring agencies, sponsors, advertisers, owners, parent companies, affiliated entities and lessors of premises (“RELEASEES”), WITH RESPECT TO ANY AND ALL ILLNESS, DISABILITY, DEATH, or loss or damage to person or property, WHETHER ARISING FROM THE NEGLIGENCE OF RELEASEES OR OTHERWISE, to the fullest extent permitted by law.

Newton’s Grove School conducts programs in the Paul Coffey Park, which may involve, but are not limited to, the following activities:

Walking to and from the Park and its facilities
Outdoor games, sports and activities
Playing on playground equipment and fields
Supervised recreation and play at recess and lunchtime
Gym classes and regularly scheduled specialist and other classes

I am aware and acknowledge that certain risks are inherent to any outdoor activities in a public place with open access to the general public. There are also inherent risks of injury while participating in sports and recreational activities on natural surfaces, regardless of degree of supervision. These types of injures may be minor or serious and may result from one’s actions, the actions or inactions of others, or a combination of both. I therefore consent to, and consent for my child, to go to the Paul Coffey Park.

Furthermore, I give consent for my, and my child’s, photograph to be used by Newton’s Grove School and any third party that is running a program at Newton’s Grove School.

Release of Liability and Assumption of Risk Agreement

I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IF FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.

Indemnity

In the event that: (a) I or my Child causes or contributes in any way to the injury or death of any person or to the damage or loss of any property, and/or (b) any Claims are made or brought against the Releasees (or any of them) in connection with any matter hereinbefore released; I shall indemnify and hold harmless the Releasees (and each of them) from and against any and all resulting or related Claims, liabilities, judgments, costs and/or expenses (including lawyer’s fees and disbursements).

Medical Waiver

I hereby authorize Newton’s Grove, a representative or staff member to secure such medical advice and services as may be deemed necessary for the health and safety of the participant. I agree to accept financial responsibility in excess of the benefits allowed by Provincial Health.

Health and General History

Should I or my child be restricted from any activity?

Yes

Please specify

Please identify any allergies, limitations, or medical conditions that you would like us to be aware of:

None

Hay Fever

Asthma

Eczema

Insect Stings

Nuts

Other

Please specify

Please identify any drug allergies or adverse reactions to medications

None

Sulpha

Penicillin

Antibiotics (specify below)

Aspirin

Other

Please specify

Have I or my child been exposed to a communicable disease in the last three weeks?

Yes

Please specify

Indemnification Agreement

I agree to indemnify and hold harmless Newton’s Grove School and its affiliates from any claims, liabilities, or costs resulting from my/my child’s participation in programs. *

Agreement to Terms

I acknowledge that this form applies to all Newton’s Grove School programs and rentals. I have read, understood, and voluntarily agree to the above terms. *

Emergency Contact & Medical Information Accuracy

I confirm that all emergency contact and medical information provided is accurate. I will update the school if any changes occur. *

Medical Authorization & Financial Responsibility

I authorize Newton’s Grove School staff to obtain medical assistance for myself/my child if necessary. I agree to accept financial responsibility for any medical expenses beyond provincial health benefits. *

Print Name

Date Signed

Parent/Guardian Signature

Sign Here

Payment

No payment items has been selected yet

For payments via e-Transfer, please send the full amount () to jmathura@newtonsgroveschool.com and include the student name, parent/guardian name, and email address.

Pay with Credit Card