Summer Camp Registration

Parent or Guardian Name *

First

Last

Email *

Phone *

Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Child's Details

Name of child to enroll *

First

Last

Allergies *

Child's gender *

Male
Female

Your relationship to the child *

Parent or legal guardian
Other

Please specify your relationship to the child if other.

Attendance Requirements

Child's age *

4-11 years old - attending primary school
11-16 years old - attending high school

Which camp are you interested in? *

Dance Evolution Camp June 29 - July 1
The Z Code Camp July 20 - July 22 (tentative schedule) - Girls Only

Which days would you like to book? *

Wednesday
Thursday
Friday

Total weekly cost *

$ 0.00

Square *

Card

Name on Card

Emergency Contact

Please provide an alternative contact person in case of emergency. Emergency contacts must be over the age of 18 and capable of caring for the child if you are unavailable.

Emergency Contact's Name *

First

Last

Emergency Contact's Phone Number

Emergency Contact's relationship to the child *

Please provide any additional contact details

Additional Comments

Summer Evolution Camp Registration

Child's Details

Attendance Requirements

Emergency Contact