Kids Club Summer Camp Registration Form
Please fill out one form per child in your family.
Email address *
Childs first and last name *
Your answer
Date of Birth
MM
/
DD
/
YYYY
Last Grade Completed *
Parents Name *
Your answer
Email address *
Your answer
Mailing Address
Your answer
Phone # *
Your answer
Secondary phone # in case of emergency
Your answer
Medical Concerns / Other Concerns
Your answer
Health card #
Your answer
Do we have permission to photograph your child for media purposes?
Submit
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