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DVMS 2019 March Break Camp
Monday, March 18 to Friday, March 22. Please make payment in full by Thursday, March 7 . Cheques can be made payable to "DVMS." Full day $230/week | please bring a healthy, litterless, packed lunch | 9:00 - 3:30
Student Information
Student Name: *
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Parent Guardian information
Primary Contact: *
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Daytime Phone number: *
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Email: *
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Secondary Contact: *
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Secondary Daytime Phone number: *
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Secondary Email: *
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Emergency/Other Contact
Contact Name: *
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Contact Relationship to Child: *
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Contact Daytime Phone: *
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Health/Medical/Allergies
Please list any/all health concerns, food allergies and restrictions, and medical issues that will help us to facilitate safe and successful participation. *
(enter "none" if no health-related issues)
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Permissions
Permission to leave DVMS for supervised walks and field trips? *
Permission to take and use photos of child? May be published on the internet. No names are made public. *
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