Day Camp Registration

Please fill out no later than 2 working day before day camp session after you have received and email confirmation that your child has been accepted.

Parent/Guardian(1) Name

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

####

Parent Guardian (2) Name

First Name

Last Name

Address (if any of this informaition is the same please type S or NA)

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

####

Please List the days and times you are interested in?

How did you hear about us?

Child One

First Name

Last Name

Birthdate

Health Care Number

Gender

Male

Female

Does your child have any allergies, recurring medical problems or special needs? If yes please explain.

What is your child's typical reaction to illness?

Child two

First Name

Last Name

Birthdate

Health Care Number

Gender

Male

Femaie

Does your child have any allergies, recurring medical problems or special needs? If yes please explain.

What is your child's typical reaction to illness?

Is there any other important information we should know?

Day Camp Registration

Who we are

Our Supporters