Camp Registration Form

Child/Children Information

Child's First & Last Name

Date of Birth

Age

Health Card Number

Medical Information

Child's First & Last Name

Date of Birth

Age

Health Card Number

Medical Information

Parent/Guardian Information

Parent/Guardian's First & Last Name

Address

Phone Number

Emergency Contact Information

First & Last Name

Address

Home Number

Cell Number

Relationship To Child

First & Last Name

Address

Home Number

Cell Number

Relationship To Child

Departure/Arrival Information

Please indicate who will be responsible for picking up your child(ren).

First & Last Name

Relationship to Child

Phone Number

First & Last Name

Relationship to Child

Phone Number

Parent/Guardian

give permission to all the people listed above to pick up the child/children listed above from the Meadowvale East Apostolic Church Summer Camp.

Sunscreen Application Information

We recommend and encourage sunscreen application before your child comes to camp. During the day, we are willing to help your child apply sunscreen unless advised otherwise. Please provide a labeled bottle of sunscreen for your child as we are unable to supply sunscreen due to health and safety concerns.

Parent/Guardian eSignature

Parent/Guardian eSignature Date

Personal Information is collected in accordance with the provisions of the Freedom of Information and Privacy Act (FIPPA). Personal information collected on this form will be used for the purposes of assisting MEAC to maintain a safe and secure summer camp. If you have questions about the collection, use and disclosure of this information, please contact Meadowvale East Apostolic Church by calling (416) 385-1140. Funded in part by Government of Canada – Canada Summer Jobs Program.

Camp Registration Form

Child/Children Information

Parent/Guardian Information

Emergency Contact Information

Departure/Arrival Information

Address

Office Hours

Food Bank Hours