Camp Northern Lights Camper Application - 2019
This form will take about 15 minutes to fill out. Fill it out ASAP so you are no disappointed. You will need the Camper's Health Card Number, Vaccination Information and Family Doctor information. Please note that the registration fee is $20 to be paid upon acceptance of an application. Please note that this year our fundraising TAG days will take place May 10-11 and your child will be contacted to help with this.
* Required
Camp Northern Lights is a member of the Ontario Camp Association
Camper's First Name
*
Your answer
Camper's Last Name
*
Your answer
Camper's Preferred Name (Optional)
Your answer
Referring agency
PVNC Catholic District School Board
KPR District School Board
Society of Saint Vincent DePaul
Children's Aid Society
Salvation Army
Big Brothers / Big Sisters
None
Other:
Street Address
*
Your answer
City
*
Peterborough
Bowmanville
Cobourg
Lindsay
Port Hope
Campbellford
Havelock
Other:
Province
*
Choose
BC
Alberta
Saskatchewan
Manitoba
Ontario
Quebec
New Brunswick
PEI
Nova Scotia
Newfoundland
Postal Code
*
Your answer
Home Phone Number
*
Your answer
Cell Phone Number
*
Your answer
Email Address
*
Your answer
Sex
*
Male
Female
Date of Birth
*
MM
/
DD
/
YYYY
Height
Your answer
Weight
Your answer
Health Card Number (all 13 digits)
*
Your answer
School Attending
Your answer
Grade (completed by Camp Time)
Choose
1
2
3
4
5
6
7
8
Next
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