Registration form for Saint Sava Serbian Winter Camp
December 2017
Camper's first and last name: *
Your answer
Names of both parents/guardians of the camper: *
Your answer
Camper's birthday: *
MM
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DD
/
YYYY
Does the camper have any allergies? IF yes then please list them here: *
Your answer
Does the camper have any other medical conditions that we should be aware of? *
Your answer
What is your address: *
Your answer
What is your home phone number: *
Your answer
Mother's mobile number:
Your answer
Father's mobile number:
Your answer
E-mail address: *
Your answer
Doctor's name: *
Your answer
Camper's medicare number: *
Your answer
Will you need extended care? *
Please list one emergency contact/alternate pick-up drop-off person (name, phone number and relation to the camper are needed): *
Your answer
On the third day, Saturday December 30th, we are meeting at and spending the day at Grouse Mountain. Will you be joining us for the day? *
Do you have any other questions and or suggestions?
Your answer
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