Registration Form

 

Fill out and register the student and all pertinent details on this page.

 

Please Choose class/camp option(s):


You must also fill out Installment Payment Plan Agreement Form if you chose either Installment Plan or Easy Plan

STUDENT INFORMATION:

Child's Home Address:


Are parents living together?

If no, who has custody of child during program hours?

PARENT (LEGAL GUARDIAN) INFORMATION

Number/Street/City/Province/Postal Code
(for field trip or volunteer purposes)
Number/Street/City/Province/Postal Code
(for field trip or volunteer purposes)

AUTHORIZED PERSON(S) INFORMATION (Other than parents/guardians)
*** To whom your child may be released if parent(s) cannot be contacted


EMERGENCY CONTACT INFORMATION (Other than Parents and Guardians)

Family Doctor


Medication or Action Taken:
(i.e. Benadryl, Epipen, etc.)



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