Summer Camp Application Form

All fields marked with a red asterisk(*) are mandatory.

Participant's Information

Surname*

Given Name(s)*
Date of Birth*

Gender*

Native Language*
Country of Citizenship*

Country of Birth*
Street*

City*
Province*

Postal Code*

Country*
Home Tel:

Cell:

Email:
Current School*

City*

Country*

Parent Information (please include at least one set of information)

Father:

(Check the box to include this information)

Surname*

Given Name(s)*

Date of Birth*
Home Tel:

Business Tel:
Cell:

Email*

Mother

(Check the box to include this information)

Surname*

Given Name(s)*

Date of Birth*
Home Tel:

Business Tel:
Cell:

Email*

Different Address Info

(Check the box if a Parent's Address is different from camper's)

Which Parent?*
Street*
City*
Province*
Postal Code*
Country*

Emergency/Recruitment Partner Information (other than Parents)

Mr. / Mrs. / Ms.*

Surname*

Given Name(s)*
Relationship to Applicant*

City*
Country*

Home/Business Tel:
Cell:

Email*

Confirmation Email

Enter your email: