Step 1 of 3 33% Child Information:Child's Name* First Last Date of Birth*(Your child must be at least 4 years old by the time camp starts on July 6)Year202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Month123456789101112Day12345678910111213141516171819202122232425262728293031Medical alert?*Does this child have any food allergies or accessibility issues? Will this child require any medication during the camp days? Yes (Please give explicit details below) No Medical Details:*Please give explicit details belowWould you like to register more children?No, just the oneYes, one more siblingYes, two more siblingsSibling Information:Child's Name* First Last Date of Birth*(Your child must be at least 4 years old by the time camp starts on July 6) Year Month Day Medical alert?*Does this child have any food allergies or accessibility issues? Will this child require any medication during the camp days? Yes (Please give explicit details below) No Medical Details*Please give explicit details belowSibling Information:Child's Name* First Last Date of Birth*(Your child must be at least 4 years old by the time camp starts on July 6) Year Month Day Medical alert?*Does this child have any food allergies or accessibility issues? Will this child require any medication during the camp days? Yes (Please give explicit details below) No Medical Details*Please give explicit details below Parent/Guardian InformationParent/Guardian Name* First Last Email* Daytime Phone:*Parent/Guardian Name First Last Email Daytime Phone:Drop-off and pick upDo you need extended child care?* No, just the regular program (9am-3pm) Yes, morning (between 8-9am) Yes, afternoon (between 3.30pm-6pm) Yes, both morning and afternoon Summer Camp Base costTotalYour total cost will be $ 0.00 CAD When will your child(ren) be picked up?*3:30 pm3:45 pm4:00 pm4:15 pm4:30 pm4:45 pm5:00 pmWho will pick up your child(ren)?*(Please note that photo ID will need to be shown at pick up) Safety and Emergency contactWhat is the best way to reach you if we need to be in touch with you urgently during the the program?* Emergency Contact* First Name Last Name Phone*Relationship to child(ren)* Photo Release and PermissionHow did you hear about our Summer Day Camp?WebsiteFacebookChurch BulletinWord of MouthOtherPhoto Release*Photographs will be taken throughout the program. May we use your child’s picture on our online and print platforms when writing about or advertising the summer day camp? Yes, you may use my child(ren)’s picture No, you may not use my child(ren)’s picture Which, if any, of the participating churches are you connected with? Church of the Transfiguration St. Augustine St. Cuthbert None of the above Guardian Permission (Name)*I hereby give permission for my child(ren) to participate in the Children’s Program outlined above Parent or Guardian Name Signature*CommentsThis field is for validation purposes and should be left unchanged. Share this:
