EARL GREY CC TOT CAMP 2018
Summer Tot Camp Registration
Child Name *
Your answer
Current Age *
Your answer
Gender *
Caregivers Full Name *
Your answer
Daytime Phone Number *
Your answer
Address *
Your answer
Postal Code *
Your answer
Email Address *
Your answer
Manitoba Health Number ( Short) *
Your answer
Manitoba Health Number ( Long) *
Your answer
Known Allergies *
Your answer
Behavior Concerns and Helpful Hints *
Your answer
Potty Tips ( or Diaper/ Pull up advice) *
Your answer
Likes and Interests *
Your answer
Dislikes and Fears *
Your answer
Weeks Attending *
Required
EMERGENCY CONTACT ( OTHER THAN YOURSELF) *
Your answer
EMERGENCY CONTACT PHONE NUMBER *
Your answer
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