Biz Camp for Kids Registration Form
July 30 - August 3 2018 in Heritage Centre Classroom for grades 4-6
Email address *
Camper's Name *
Your answer
Date of birth *
MM
/
DD
/
YYYY
Home Phone # *
Your answer
Mailing Address *
Your answer
Parent / Guardian Info (Primary Contact)
Name *
Your answer
Relation to camper *
Your answer
Email *
Your answer
Contact Phone *
Your answer
Parent / Guardian Info (Secondary Contact)
Name *
Your answer
Relation to camper *
Your answer
Contact Phone *
Your answer
Medical Information
Allergies or medications *
Your answer
Emergency Contact (name & phone number) *
Your answer
A copy of your responses will be emailed to the address you provided.
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