2018 Summer Registration
Please fill out 1 form per child fully. No partial information.

$800/month
$300/week

Email address *
Child's Last and First Name *
Your answer
Parent's First and Last Name *
Your answer
Phone Number (Please mention whose number. Ex. mom - 111-111-1111) *
Your answer
Child's Address with postal code *
Your answer
Parent's Address if Different than Child's with postal code(child resides in more than one home)
Your answer
Emergency Contact Name (Can not be yourself) *
Your answer
Emergency Contact Phone Number *
Your answer
Emergency Contact Address with Postal Code *
Your answer
Child's Birthdate *
Your answer
Child's Alberta Health Care Number *
Your answer
Medical/Allergies *
Your answer
Medication/Inhalers/Epi Pens Needed? *
Immunizations up to date? *
Walk home alone? *
Additional Contacts
Your answer
Care Needed *
Required
$50 Non Refundable Fee (Due on Mar.8/18) Fee goes towards amount owing. *
Signature of Parent (Type full name) *
Your answer
Submit
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