Summer Camp 2017 - Registration Form
Mailing Address: 117 Chatillon, Dollard Des Ormeaux, Quebec, H9B 1B4
Telephone Number: 514-941-8404
E-mail: evan@sport-life.ca
Website: www.sport-life.ca
CAMPER
Please send a digital picture of your child to evan@sport-life.ca (new campers only).

This image will be used for our Monday Draft.

First Name *
Your answer
Last Name *
Your answer
Gender *
Required
Age *
(as of June 26, 2017)
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Home Address *
Your answer
City *
Your answer
Postal Code *
Your answer
School *
Your answer
Grade Completed *
(as of June 26, 2017)
Your answer
PARENTS
Day camp fees are tax deductible. Please provide the full name of both parents and either the mother's OR father's social insurance number, as it appears on their social insurance card for tax receipt purposes (Releve 24).
Mother's Name *
Your answer
Social Insurance Number
Your answer
Father's Name *
Your answer
Social Insurance Number
Your answer
PHONE NUMBERS & E-MAIL
Home
Your answer
Mother Work Phone
Your answer
Mother Cell Phone
Your answer
Mother E-mail *
Your answer
Father Work Phone
Your answer
Father Cell Phone
Your answer
Father E-mail *
Your answer
EMERGENCY CONTACT
(other than parents)
Name
Your answer
Relationship to Child
Your answer
Home Phone
Your answer
Work Phone
Your answer
Cell Phone
Your answer
LANGUAGES
First Language
Your answer
Languages Spoken
Your answer
REGISTRATION
Camp will be open Monday through Friday for all 9 weeks, including all holidays.

Note: ICE HOCKEY REGISTRANTS MUST ALSO SEND IN THE ONLINE ICE HOCKEY INFORMATION FORM.

Note: WEEK 9 TENNIS WILL TAKE PLACE AT THE BEAUTIFUL CLUB COTE DE LIESSE

Little Leaguers
(Age: 5-6)
Rookies & All-Stars
(Age: 7-15)
BUS/VAN TRANSPORTATION SERVICE (optional)
Will you be taking advantage of this bus service? *
Please specify which weeks.
Required
FREE SWIM! (optional)
Will you be taking advantage of this swim service? *
Please specify which weeks.
Required
EXTENDED DAY SERVICES (optional)
Extended Hours (Extended AM: 7:30am-8:30am; Extended PM: 3:45pm-6:00pm) *
7:30am-8:00am - $5; 8:00am-8:30am - $3; 4:00pm-5:00pm - $5; 5:00pm-6:00pm - $8
SPORTLIFE T-SHIRTS (optional)
Please check out our AMAZING DISCOUNTS below!

Additional merchandise soon available for purchase at the bottom of the form or at www.sport-life.ca/shop

Merchandise ordered before June 10, will be available for pick-up on Day 1 of Camp!

Type of T-Shirt
Classic Tee ($15) or Customizable Player Tee ($25)
T-Shirt Size
T-Shirt Colour and Quantity
Colors: Black, Red, Yellow, Purple, White (NEW). Ex: Red/2, Black/1,
Your answer
Player Name
For Player Tee only. (Max: 10 Characters)
Your answer
Player Number
For Player Tee only. (Numbers: 0-99)
Your answer
Black Tee Font Color
For Player Tee only.
Red Tee Font Color
For Player Tee only.
Yellow Tee Font Color
For Player Tee only.
Purple Tee Font Color
For Player Tee only.
White Tee Font Color (NEW)
For Player Tee only.
GENERAL INFORMATION
Are there any special friends that you would like to have in your child's group?
Your answer
Allergies, medications being taken and/or other pertinent medical information
Your answer
Is there any other information that you think we should know about?
Your answer
HOW DID YOU HEAR ABOUT US? *
Required
REGISTRATION PAYMENT
Please provide a separate cheque for: Registration, Bus, Swim & Merchandise.
Method of Payment *
e-Transfer (preferred), cheque or cash
Your answer
Name on Cheque
Your answer
Cheque #
Your answer
Amount *
Your answer
BUS PAYMENT
Method of Payment
e-Transfer (preferred), cheque or cash
Your answer
Name on Cheque
Your answer
Cheque #
Your answer
Amount
Your answer
SWIM PAYMENT
Method of Payment
e-Transfer (preferred), cheque or cash
Your answer
Name on Cheque
Your answer
Cheque #
Your answer
Amount
Your answer
T-SHIRT/MERCHANDISE PAYMENT
Method of Payment
e-Transfer (preferred), cheque or cash
Your answer
Name on Cheque
Your answer
Cheque #
Your answer
Amount
Your answer
TERMS & CONDITIONS
The parties hereto have agreed that this agreement be prepared and executed in the English language.
Les parties ont convenu que cet accord soit préparé et exécuté dans la langue anglaise.
Parent's Name *
Your answer
E-mail Address *
Your answer
Date *
Your answer
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