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Salam Shop MARCH BREAK Camp
Pay for camp here:
https://www.paypal.com/cgi-bin/webscr?cmd=_s-xclick&hosted_button_id=FU4Q3STEX9A72
...then fill out this form to ensure your child reserves a spot at the Salam Shop March Break Camp!
*Payment is non-refundable and non-transferrable*
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PERSONAL INFORMATION
Student Name:
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Your answer
Birth Date (Day / Month / Year):
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Your answer
Home Address including Postal Code:
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Your answer
Home Telephone Number:
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Your answer
Parent's Names & Contact Numbers (Home / Work / Cell):
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Your answer
Who made the payment on Paypal for this camp? (Name + Email)
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Your answer
EMERGENCY CONTACT INFORMATION
Name of Emergency Contact:
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Your answer
Phone Number:
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Your answer
Relationship to Child:
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Your answer
Child Allergies:
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Your answer
Does your child carry an EPI pen?
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Yes
No
In the event of an emergency, may we release your child to your emergency contact?
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Yes
No
In the event of an emergency in which we cannot contact a parent or emergency contact, may release your child to a physician for care?
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Yes
No
CAMP INFORMATION
Have you made payment online of $100 + HST ($113.00)?
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Yes
No
Would you like the option of early drop off and late pick up, ie: instead of 10am - 2pm, 9am to 3pm.
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Yes
No
Do we have permission to use photos taken at camp of your child for marketing or advertising purposes?
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Yes
No
You will receive an email in 2-3 days with a list of items your child should bring to camp :) You will also be emailed a camp liability release form that must be signed and dated before your child can attend camp.
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