Summer Camp Registration 2019

Please complete this form on a computer or laptop only! The mobile version of the form is temporarily unavailable

Camper's First Name*

Camper's Last Name*

Camper's Gender*
MaleFemale

Date of Birth*

/ /

Select the session you want to register for*
2 weeks: Jul 14-July 28, Session 1.
2 weeks: Jul 28-Aug 11, Session 2.
1 week: Jul 14-July 21.
1 week: July 21-July 28.
1 week: Jul 28-Aug 4.
1 week: Aug 4-Aug 11.
4 weeks: Jul 14-Aug 11.
other

Select your payment*
2 weeks Refer a Friend: $515*2+$134 HST=$1164
2 weeks: $580*2+$151 HST=$1311
1 week Refer a Friend price $545+$71 HST=$616
1 week $598+$78 HST=$676
4 weeks promo price $490*4+$255 HST=$2215
3 weeks promo price $495*3+$193 HST=$1678

To get Refer a Friend price, please provide the name of the friend you recommended/ you're recommended by:

Parent/Guardian Name(s) that will be used on camp receipt*

EXTRA PROGRAMS (Already included in camp fee)

Leadership-in-Action Certification Programs (details: Leadership Program)
-For 13-16 years ONLY. -Attendance of 2 weeks is required

Leadership IntroductionLeadership Advanced ( for those who completed Leadership Introduction

Boot Camp/Weight Management Program (details: Boot Camp Program)
add BootCamp

English Classes (details: English Classes)
add English Classes

Grouping request, if any. I want to be with the following campers:

How did you know about us?*

FAMILIY INFORMATION

First Parent or Guardian

Full Name*

Contact Phone*

Contact Email*

Second Parent or Guardian

Full Name

Contact Phone

Contact Email

Child's Home address

Street Address*

City*

Zip or Postal Code*

Country*

Family Status

Custody

Please provide Custody Details*:

I give my authorization for over the counter medication*:

DiscoveryLand Camp Policy, Terms and Conditions:

By SUBMITTING this form I acknowledge that I have carefully read, understood and agree to the DiscoveryLand Camp Terms and Conditions

Parent/ Guardian - Responsible for camp registration:

Parent/ Guardian Name*

Parent/ Guardian's Email*

*

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