Fall 2017 Lake Bonavista Registration
Please complete all areas or registration will be declined
Child Last and First Name *
Your answer
Parent's First and Last Names *
Your answer
Phone Number *
Your answer
Child's Address with postal code *
Your answer
Parents Address if different with postal code
Your answer
Emergency Contact Name *
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 Number *
Your answer
Medical/Allergies
Your answer
Medication/Inhalers/Epi Pens Needed? *
Immunizations up to date? *
Walk Home Alone? *
Additional Contacts
Your answer
Email Addresses *
Your answer
$50 Non Refundable Fee *
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms