Camper Information & Contract



 Occupant Full Name: _______________________________________________________

Permanent Home Address: ___________________________________________________

City/Town: ________________Province: _____________Postal Code: _______________

Email:  ______________________________

Telephone Number – residence: _______________________ work: __________________

Trailer Make:_____________________ cell: ___________________

Is address on license the same as permanent home address Yes _____ No _____

Car License Plate #: _____________________________ Make: _________________

ATV Make: ___________________________________ Boat Make: _____________

Proof of Insurance on trailer: _______________________________________________________

Emergency Contact: _____________________________Relationship:______________________

Telephone Number: _________________________

The Owner has agreed to license the Occupant to occupy the following site address

Lot #___________________________________________ with the services specified.


This license is personal to the above-named Occupant and those eligible family members listed below:

Partner: _____________________________

List unmarried dependent children 18 years and under, living at permanent home address:

Name: ______________________________      Date of Birth: _________________________

Name: ______________________________      Date of Birth: __________________________

Name: ______________________________       Date of Birth: _________________________

This Agreement signed the __________(day) of  _________(Month), ______(Year), at Whitefish, Ontario shall be binding upon the heirs, executors, administrators and assigns of the parties hereto.


Signed and Delivered in the presence of

________________________        ________________    ___                 X_______________________

Name of Witness (Print)                        Name of Owner                                            Name of Occupant (Print)

_______________________        ____________________                        X___________________

Signature of Witness                              Signature of Owner                                           Signature of Occupant



I, the named Occupant for the specified site, acknowledge providing the personal information pursuant to this contract and confirm the accuracy of the same. I, the named Occupant, consent to the disclosure of this personal information for the use of the owner as required from time to time to administer and enforce the agreement between the parties to this contract.


X_________________________________                         X_____________________________________

Date                                                                                                           Signature of Occupant




                                             ID                                                                                        INSURANCE

                                           HERE                                                                                        HERE