Request edit access
DVMS 2019 Summer Camp
Payment is due at the time of registration. Please make payment by email money transfer to accounts@dvms. Please make the password “Camp2019”. (If your bank's e-transfer has different password requirements, please include password in a separate email to accounts@dvms.ca). Please note that children must be turning 4 in 2019 and be toilet trained.
Student Name *
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Please Select Program: *
Required
Please Select Which Weeks: (Weekly theme information is located on our website) *
Required
Parent Contact Information
Your answer
Daytime Cell Phone Number
Your answer
Email
Your answer
Secondary Contact Information
Your answer
Secondary Contact Daytime Cell Number
Your answer
Secondary Contact Email Address
Your answer
Emergency Contact (Other than Parent) *
Your answer
Emergency Contact Relationship to Child *
Your answer
Emergency Contact Cell Phone *
Your answer
Emergency Contact Email *
Your answer
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) *
Your answer
Permission to take and use photos of your child? (photos may be published on our website without names) *
Permission to leave school property for nature hikes? *
Submit
Never submit passwords through Google Forms.
This form was created inside of Dundas Valley Montessori School. Report Abuse - Terms of Service