Register for Summer Camp 2011

Register Your Child
Registering for:
Camper Information
Camper's Name
Camper's Age
Camper's Birthdate
Gender
Medicare Number
Medicare Expiry
Medical Insurance Company (if American)
Policy Number
Expiry Date
Family Doctor
Allergies (food)
Allergies (medication)
Medications
Medical Conditions
Parent's Information
Parent's Name
Street Address
City
Province
Postal Code
Email Address
Phone Number (work)
Phone Number (home)
Additional Contact Person
Their Name
Their Home Phone
Their Work Phone
Relationship to Camper  
Name of Person Picking up Child
Notes (allergies, etc.)
Parents will be required to complete a medical information form for each camper when dropping off their child.