Summer Boost Camp 2020 Registration
Parent Contact Information
Parent First Name: *
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Parent Last Name: *
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Address (including postal code): *
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Phone Number: *
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Email: *
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Alternate Parent/Guardian/Caregiver - Name, Relationship, and Number: *
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Emergency Contact - Name, Relationship, and Number (include cell and work number when relevant): *
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How did you hear about this camp?
Camper Details
Child First Name: *
Your answer
Child Last Name: *
Your answer
Grade entering in September 2019: *
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Camp Dates
Select that camp(s) you'd like to register for: *
Required
Language Skills Development
Select your preference: *
Medical Information
Camper's Date of Birth: *
MM
/
DD
/
YYYY
Camper's BC Care Card Number: *
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Please indicate any medical information or allergies (if this does not apply, please type "N/A"): *
Your answer
Parent/Guardian Consent:
*
Required
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Required
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Signature (type Parent/Guardian Name): *
Your answer
Relationship to Camper *
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