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Home
About Us
Summer Camp
After School
Additional Programs
Galleries
Contact
2024 Summer Camp Registration Form
Full Name
Name
*
Please enter your Name
Address
Address
City
Province
- Please Select -
ON
QC
NS
NB
MB
BC
PE
SK
AB
NL
NT
YT
NU
Postal Code
Personal
Home Phone
*
Please enter your Home Phone
Please enter your valid Home Phone
Age
Date of Birth (dd/mm/yy)
Email Address
*
Please enter your Email
Please enter a valid Email Address
Choose Week(s)
July 2nd - 5th
July 8th - 12th
July 15th -19th
July 22nd - 26th
July 29th - August 2nd
August 6th - 9th
August 12th -16th
August 26th - 30th
Mother’s Info
Mother's Name
Use as primary contact
Mother's Phone
Mother's Business
Mother's Cell
Father’s Info
Father's Name
Use as primary contact
Father's Phone
Father's Business
Father's Cell
Emergency Contact
Emergency Contact (if different from above)
Relationship to student
Emergency's Phone
Emergency's Business
Emergency's Cell
Health Information
Family Doctor
Family Doctor Phone
Health Card No
Health, Learning or Behavior Concerns
Yes
No
If "Yes", please give details
Does this participant carry and know how to administer his/her medication?
Other Informtion (e.g. Braces, Contact lenses etc)
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