Kid Application for Camp Contribution 2017
Please complete 1 application per child.

Camper & Parent Information

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* Child's First Name

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* Child's Last Name

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* Child's Gender

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* Child's Birthdate (Child must be 9 to 12 years old during camp)

Birthdate

Date

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* Child's School

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* Parent/Guardian Name

First Name

Last Name

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* Relationship to Child

Mother

Father

Other (please specify)

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* Parent/Guardian Email

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* Phone Number

Home

Work

Mobile

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* Home Address

Street Number & Address

City

Province

Postal Code

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20% of survey complete.