Winter Camp Registration

Parent or Guardian

Parent/Guardian Name*

First Last

Address*

Street Address City Postal Code

Phone*

Email*

Relationship to child*

Name*

Contact Number*

Relationship*

Name*

Contact Number*

Relationship*

Child Name*

First Last

Name Goes By

Birthdate*

Pronoun

Medical Number

Family Doctor

Allergies/Medication

Can they self administrator meds?*

Medical Condition/Exceptional Behaviours:

Pay for all 7 days

Choose which weeks you are registering for

Pay by the day

Choose which days you are registering for

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Registration Cost

Total

$ 0.00 CAD

Payment Method*

Your spot won't be guaranteed until full payment has been received.