Camp Chief Hector YMCA:

Group Name:

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Contact Name:

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Address:

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City:

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Province or Territory:

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Postal Code

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Daytime Phone:

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Alternate Phone

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Fax:

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Email:

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Number of Adults

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Number of children/youth

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In what space are you interested?

Check all that apply

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Meals Required?

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Arrival Date:

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Arrival Time:

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Departure Date:

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Departure Time:

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Do you require activity Facilitation?

See list below

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Tell us more about your interests and needs

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