PA Day Camp 2022-2023 Registration

PA Day Camp Registration

Please fill out the form below to complete your PA Day Camp 2022-2023 Registration
Personal Information
Camper/Child Name*

First NameLast Name
Camper/Child Birth Date

MonthDayYear
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent / Guardian Name*

First NameLast Name
Phone Number*

Area CodePhone Number
Parent/Guardian/Contact E-mail*
example@example.com
If there is more than one parent and/or guardian please provide their name and contact number below.
Parent / Guardian Name

First NameLast Name
Phone Number

Area CodePhone Number
Parent/Guardian/Contact E-mail
Does your Camper/Child have any allergies?*

YesNo
Please list any allergies your Camper/Child may have.
Diabetes*

YesNo
Epilepsy*

YesNo
Emergency Contact
Name*

First NameLast Name
Phone Number*

Area CodePhone Number
Relationship to Camper/Child*
In the event of an emergency. may we release your camper/child to your emergency contact?*

YesNo
Extended Care
Extended Care is offered from 7:30am - 6:00pm at a charge of $10.00/1hr and must be prepaid through the front desk prior to or on the first day of Camp.
Please provide both Dates and Times you will be needing Extended Care. If you are not purchasing Extended Care please leave blank.
**Only required If you are purchasing Extended Care.
Payment
Please feel free to contact us with any questions or concerns you may have prior to your purchase.

Please choose your camp date (Full Day or Half Day)*

Friday, November 25, 2022 - FULL DAY$94.99CAD

Friday, November 25, 2022 - HALF DAY$59.99CAD

Friday, January 27, 2023 - FULL DAY$94.99CAD

Friday, January 27. 2023 - HALF DAY$59.99CAD

Friday, February 17, 2023 - FULL DAY$94.99CAD

Friday, February 17, 2023 - HALF DAY$59.99CAD

Monday, April 24, 2023 - FULL DAY$94.99CAD

Monday, April 24, 2023 - HALF DAY$59.99CAD

Monday, June 5, 2023 - FULL DAY$94.99CAD

Monday, June 5, 2023 - HALF DAY$59.99CAD

Enter coupon

Subtotal $0.00CADTax $0.00CADTotal $0.00CAD

PA Day Camp Registration