Name of Attendee (Required)
Please use the section below to advise us of any medical or support needs that your child may require.
To care for your child to the best of our ability, please describe any other physical, emotional or behavioural problems:
This section may also be used to share specific needs, requirements, supports or adjustments that may be required in our programming. Some examples may include an additional support such as a respite care worker or assistive devices at your expense, however, we cannot provide that service. (communication device, iPad, etc.)
All information will remain confidential. Please state what date(s)/time(s) you need before and aftercare. Starting at 8am for before, and 4:30pm being the latest. Please bring exact cash day of, or cheque covering however many days you require. Every half hour is $10
Leave blank if none
Parent / Guardian Information Address
Emergency Contact Information Name
We reserve the right to decline any child's admission to camp if it the needs of the child are beyond the standard level of care. Please ensure this form is filled out accurately so appropriate steps can be taken for the wellbeing of your child.