Play Cafe's Camp Registration
Play Cafe Summer Camp!
Weeks available:
Preschool Camp (July 15-19)
School Age -Tuesday - Friday (August 6th - 9th)
School Age- Monday - Friday (August 12th - 16th)
School Age- Monday - Friday (August 19th - 23rd)
School Age- Monday - Friday (August 26th - 30th)
Email address *
Which Camp Week do you want to attend? *
Child's Name (First and Last) *
Your answer
Child's Birthdate: *
Your answer
Parent/Guardian Name: *
Your answer
Address: *
Your answer
Phone Number: *
Your answer
Your answer
Allergies/Medical History (Please provide any relevant information regarding medical conditions, including physical restrictions and allergies) : *
Your answer
Full payment is required to hold your spot. The fee is $125 + HST ( Week 1 $100 +HST) You can email transfer to , Call 874 3517, paypal, or come in with cash, credit, debit payments. Let me know how you wish to send payment. *
DECLARATION I, the undersigned, being the parent/legal guardian of , declare that the information and medical details on this registration form are correct to the best of my knowledge and I hereby apply for a place at Play Cafe for my child or ward. I understand that Play Cafe reserves the right to restrict admission at its own discretion. *
I grant permission for my child or ward to participate in all activities, except as indicated under ‘Medical History’, and I understand that Play Cafe provides no health insurance or medical coverage and that the signing of this form acknowledges my responsibility for payment of any medical treatment which may be required while my child or ward is participating in classes at the school. I further grant permission for Play Cafe or its representatives to procure any and all necessary medical help for my child or ward while they are under the supervision of Play Cafe or its representatives to permit any competent medical person to take all reasonable measures to treat any injury or sickness that my child or ward may suffer.
Release : By sending this form I hereby state that I release all members of Play Cafe staff and any other party involved in the organization and administration of Play Cafe from any liability as a result of any injury sustained in or around Play Cafe or Dominion Park. Privacy: I understand that all information supplied on this form will be kept strictly confidential. *
Important Information:

You will get an email closer to camp dates but here is some info to keep in mind.
Campers are required to bring:

A packed healthy lunch if your child is staying until 1pm
(You have the option to pick up at 12:30 and take your child home for lunch)
(No nuts/peanuts please)
Water Bottle
Change of clothes (weather appropriate)

Safety is very important to us, and we always strive to accommodate a 8:1 ratio*.

All of our camp counsellors have many years of experience working with children and training in First Aid and CPR.

Our camps are not intended for children who require one-on-one camper to teacher support. Our activities are group activities which require that all children are able to safely participate in the planned curriculum including off-site park activities. Please contact us before registering if you are unsure if your child can safely participate.

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