Summer Camp Registration Form

Child Information

Name *

First

Last

Date of Birth *

Parent/Guardian Information

Name *

First

Last

Email *

Phone *

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Emergency Contact

Name *

First

Last

Phone *

Name of Current School

Please provide names and details of any other campers that you know who are coming and if you'd prefer them to be in the same room or separate or any relevant information that would help them make the most of their week.

Does your child have any medical or pastoral needs? *

Yes
No

Medical information or pastoral concerns *

Please provide a list of any medical information or pastoral concerns and please list if any medication or provisions will be required. Pastoral concerns may include night terrors, sleep walking, wetting the bed etc.

Does your child have any dietary requirements? *

Yes
No

Dietary Requirements *

Please list any dietary requirements or intolerances.

Please provide us with any other information you think might be relevant or good for us to know.

Save and Resume Later

Child Information

Parent/Guardian Information

Emergency Contact

Activity Class Selection

Photography and Film Permission

Terms and Conditions