Student Name *

First Name

Last Name

Student Birthdate *

MM

DD

YYYY

I will be needing before/after camp care for my child *

Camp hours are 9:30 - 3:30 daily. Before-camp care begins at 8:45, and after-care pick up ends at 5:00. Please add extended care to your cart when paying your camp fees.

YES

NO

Parent/Guardian *

First Name

Last Name

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Alternate/Emergency Contact for Camp

(if different from parent/guardian)

First Name

Last Name

Alternate/Emergency Contact Phone

(###)

###

####

Does this person have permission to pick your child up from camp?

YES

NO

Is your child permitted to sign themselves out and go home unsupervised at the end of the camp day? *

YES

NO