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Summer Day Camp Registration Form 2011

Cheques should be made payable to Trafalgar Castle School.

Confirmation of registration will be mailed upon receipt of payment.

Trafalgar Castle School
401 Reynolds St.
Whitby, ON, L1N 3W9

Voice Mail: 905-668-3358 ext. 610

Fax: 905-668-4136

$35.00 Cancellation Fee applicable after June 1, 2011.
NOTE: Post-dated cheques will NOT be accepted.

Your eMail Address
Camper's First Name
Camper's Last Name
Gender
Age (at time of camp)
Birthdate
Returning Camper? Yes   No
Street Address
City
Postal Code
Name of Parent(s)/Guardian(s)
Home Phone #:
Business #
Cellular #
Emergency Contact Name
Emerg. Phone #
Emerg. Business #
Emerg. Cell #
Health Card #
Physician's Name
Physician's Phone #
Medical Concerns / Allergies
Food Allergies / Diet Restrictions
Week 1: July 4 - July 8 Regular Hours - $205.00
Extended Hours - +$40.00
Week 2: July 11 - July 15 (FULL)
Week 3: July 18 - July 22 (FULL)
Week 4: July 25 - July 29 Regular Hours - $205.00
Extended Hours - +$40.00
Week 5: Aug. 2 - Aug. 5 Regular Hours - $164.00
Extended Hours - +$40.00
Week 6: Aug. 8 - Aug. 12 (FULL)
Counsellor-In-Training Program (Ages 13 and Up)
C.I.T. Session 1: July 4 - July 15 $250.00
C.I.T. Session 2: July 18 - July 29 $250.00
C.I.T. Session 3: Aug. 2 - Aug. 12 $250.00
C.I.T. T-shirt Size (T-shirt is included in C.I.T. fee and is for C.I.T.'s only) N/A
XS
S
M
L
XL
XXL
Please call ext. 610 to check Swimming Lesson availability (+$125.00)
Swimming Level
Please group me with:
(Group members must be the same age)
Photo Consent* Yes   No
*I hereby consent and authorize Trafalgar Castle School to photograph and/or videotape my child and authorize the School to use such photographs for all purposes which it deems proper (ie. website, promotional material). I do hereby release Trafalgar Castle School from any and all claims for damages, libel, slander, invasion or privacy or for any other claim based on the use of said material.