Camp Inspire - Registration Form
Camp Address: 101 Symmes Street (Community Hall behind the Church), Gatineau (Old Aylmer sector)
Contact us at (613) 784-9309 or
Camper's First and Family Name
Age of Camper
Parent or Guardian's First and Family Name
Home or Primary Phone Number
Secondary Phone Number
Camper's Home Address
Which weeks will you attend?
Each week has a specific theme. Check off all weeks that you would like to attend.
Week 1 - June 25 to 28 - Theme: Summertime
Week 2 - July 2 to 5 - Theme: Community and Family
Week 3 - July 8 to 12 - Theme: Race and Place
Week 4 - July 15 to 19 - Theme: Religions and Indigenous Cultures
Week 5 - July 22 to 26 - Theme: Cultures
Week 6 - July 29 to August 3 - Theme: Four Elements
Week 7 - August 5 to 9 - Theme: Animals
Week 8 - August 12 to 16 - Theme: Plants
Week 9 - August 19 to 23 - Theme: The Future
What are your child's favourite foods (other than junk food)?
Do you require pre- or after care?
Pre-Care (8:00 am to 9:00 am) - $5 per
After-Care (4:00 pm to 5:30 pm) - $5 per
I accept that photos or video will be taken of my child while at Camp Inspire.
Yes, for sharing with me and for promotional purposes of next year's Camp Inspire.
Yes, for sharing with me only.
No, I don't want my child photographed or recorded on video.
I understand that Camp Inspire and its employees are not liable for injury to my child or responsible for the loss or theft of my child's property.
By clicking "I agree" below and submitting this form, I agree to pay a deposit of 25% of the total fee within 24-hours of registration to reserve the indicated dates for my child. I understand that the deposit is non-refundable. The subsequent 75% is to be paid in full before end of day, June 21 (unless otherwise agreed to in writing by Natalie Fraser).
A copy of your responses will be emailed to the address you provided.
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