If you are a human, do not fill in this field. Daycamp Registration 2019Tell us about yourself and your child(ren) Page 1 of 5Parent/Guardian FIRST Name*Parent/Guardian LAST Name*Email*AddressCityProvinceQuebecOntarioManitobaSaskatchewanAlbertaBritish ColumbiaYukonNorthwest TerritoriesNunavutNewfoundland & LabradorPrince Edward IslandNew BrunswickNova ScotiaPostal CodeTelephone #1*##########Telephone #2##########Emergency Contact NameEmergency Contact RelationshipEmergency Contact TelephoneCommentsPreviousNextPage 2 of 5CHILD 1Child 1 FIRST Name*Child 1 LAST Name*Grade Entering (Fall 2019)*Grade 1Grade 2Grade 3Grade 4Grade 5Grade 6Sec 1Gender* Female MaleDate of Birth (MM/DD/YEAR)*RAMQ (Health Card Number)*RAMQ Expiration (YEAR/MM)*AllergiesMedical ConcernsCommentsPreviousNextPage 3 of 5CHILD 2Child 2 FIRST NameChild 2 LAST NameGrade Entering (Fall 2019)Grade 1Grade 2Grade 3Grade 4Grade 5Grade 6Sec 1Gender Female MaleDate of Birth (MM/DD/YEAR)RAMQ (Health Card Number)RAMQ Expiration (YEAR/MM)AllergiesMedical ConcernsCommentsPreviousNextPage 4 of 5CHILD 3A description of the section goes here.Child 3 FIRST NameChild 3 LAST NameGrade Entering (Fall 2019)Grade 1Grade 2Grade 3Grade 4Grade 5Grade 6Sec 1Gender Female MaleDate of Birth (MM/DD/YEAR)RAMQ (Health Card Number)RAMQ Expiration (YEAR/MM)AllergiesMedical ConcernsCommentsPreviousNextPage 5 of 5REGISTRATION TOTALPlease select how many children you are registering:* 1 CHILD ($115) 2 CHILDREN ($230) 3 CHILDREN ($345)TOTAL REGISTRATION Payment options Pay with PayPal. PreviousNextSubmit Submit
