Form
Boswin Summer Camp
Western Mississauga Location
Student Information
Name
*
First Name
Middle Name
Last Name
Date of Birth
*
-
Month
-
Day
Year
Date
Gender
*
Please Select
F
M
Home Address
*
Street Address
Street Address Line 2
City
Province
Postal Code
School
*
Guardian 1 Information
Name
*
First Name
Last Name
Relationship to student
*
Home Phone
Please enter a valid phone number.
Cell Phone
*
Please enter a valid phone number.
Email
*
example@example.com
Guardian 2 Information
Name
First Name
Last Name
Relationship to student
Home Phone
Please enter a valid phone number.
Cell Phone
Please enter a valid phone number.
Email
example@example.com
Primary Emergency Contact
Name
*
First Name
Last Name
Home Phone
Please enter a valid phone number.
Cell Phone
*
Please enter a valid phone number.
Email
*
example@example.com
Secondary Emergency Contact
Name
*
First Name
Last Name
Home Phone
Please enter a valid phone number.
Cell Phone
*
Please enter a valid phone number.
Email
example@example.com
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Does the student have any other medical conditions that we need to be aware of? If yes, please specify.
*
Does the student have any allergies that we need to be aware of? If yes, please specify.
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My Products
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Academic Camp (Early Bird Rate)
Enter description
$
155.00
CAD
Quantity
Price
June 30th
1
$
155.00
CAD
July 7th
1
$
194.00
CAD
July 14th
1
$
194.00
CAD
July 21st
1
$
194.00
CAD
July 28th
1
$
194.00
CAD
August 5th
1
$
155.00
CAD
August 11th
1
$
194.00
CAD
August 18th
1
$
194.00
CAD
August 25th
1
$
194.00
CAD
Extended Hours
$
55.00
CAD
Quantity
Price
June 30th
1
$
55.00
CAD
July 7th
1
$
69.00
CAD
July 14th
1
$
69.00
CAD
July 21st
1
$
69.00
CAD
July 28th
1
$
69.00
CAD
August 5th
1
$
55.00
CAD
August 11th
1
$
69.00
CAD
August 18th
1
$
69.00
CAD
August 25th
1
$
69.00
CAD
Extended Hours Mornings
$
27.00
CAD
Quantity
Price
June 30th
1
$
27.00
CAD
July 7th
1
$
33.00
CAD
July 14th
1
$
33.00
CAD
July 21st
1
$
33.00
CAD
July 28th
1
$
33.00
CAD
August 5th
1
$
27.00
CAD
August 11th
1
$
33.00
CAD
August 18th
1
$
33.00
CAD
August 25th
1
$
33.00
CAD
Extended Hours Afternoons
$
36.00
CAD
Quantity
Price
June 30th
1
$
36.00
CAD
July 7th
1
$
45.00
CAD
July 14th
1
$
45.00
CAD
July 21st
1
$
45.00
CAD
July 28th
1
$
45.00
CAD
August 5th
1
$
36.00
CAD
August 11th
1
$
45.00
CAD
August 18th
1
$
45.00
CAD
August 25th
1
$
45.00
CAD
French Camp (Early Bird Rate)
$
155.00
CAD
Quantity
Price
June 30th
1
$
155.00
CAD
July 7th
1
$
194.00
CAD
July 14th
1
$
194.00
CAD
July 21st
1
$
194.00
CAD
July 28th
1
$
194.00
CAD
August 5th
1
$
155.00
CAD
August 11th
1
$
194.00
CAD
August 18th
1
$
194.00
CAD
August 25th
1
$
194.00
CAD
Half-Day Academic Camp
$
120.00
CAD
Quantity
Price
June 30th
1
$
120.00
CAD
July 7th
1
$
150.00
CAD
July 14th
1
$
150.00
CAD
July 21st
1
$
150.00
CAD
July 28th
1
$
150.00
CAD
August 5th
1
$
120.00
CAD
August 11th
1
$
150.00
CAD
August 18th
1
$
150.00
CAD
August 25th
1
$
150.00
CAD
Half-Day French Camp
$
120.00
CAD
Quantity
Price
June 30th
1
$
120.00
CAD
July 7th
1
$
150.00
CAD
July 14th
1
$
150.00
CAD
July 21st
1
$
150.00
CAD
July 28th
1
$
150.00
CAD
August 5th
1
$
120.00
CAD
August 11th
1
$
150.00
CAD
August 18th
1
$
150.00
CAD
August 25th
1
$
150.00
CAD
Half-Day Junior Robotics Camp
$
144.00
CAD
Quantity
Price
June 30th
1
$
144.00
CAD
July 7th
1
$
180.00
CAD
July 14th
1
$
180.00
CAD
July 21st
1
$
180.00
CAD
July 28th
1
$
180.00
CAD
August 5th
1
$
144.00
CAD
August 11th
1
$
180.00
CAD
August 18th
1
$
180.00
CAD
August 25th
1
$
180.00
CAD
Half-Day Minecraft Education Camp
$
144.00
CAD
Quantity
Price
June 30th
1
$
144.00
CAD
July 7th
1
$
180.00
CAD
July 14th
1
$
180.00
CAD
July 21st
1
$
180.00
CAD
July 28th
1
$
180.00
CAD
August 5th
1
$
144.00
CAD
August 11th
1
$
180.00
CAD
August 18th
1
$
180.00
CAD
August 25th
1
$
180.00
CAD
Half-Day Primary Robotics Camp
$
144.00
CAD
Quantity
Price
June 30th
1
$
144.00
CAD
July 7th
1
$
180.00
CAD
July 14th
1
$
180.00
CAD
July 21st
1
$
180.00
CAD
July 28th
1
$
180.00
CAD
August 5th
1
$
144.00
CAD
August 11th
1
$
180.00
CAD
August 18th
1
$
180.00
CAD
August 25th
1
$
180.00
CAD
Junior Coding Camp (Early Bird Rate)
$
184.00
CAD
Quantity
Price
June 30th
1
$
184.00
CAD
July 7th
1
$
230.00
CAD
July 14th
1
$
230.00
CAD
July 21st
1
$
230.00
CAD
July 28th
1
$
230.00
CAD
August 5th
1
$
184.00
CAD
August 11th
1
$
230.00
CAD
August 18th
1
$
230.00
CAD
August 25th
1
$
230.00
CAD
Junior Robotics Camp (Early Bird Rate)
$
184.00
CAD
Quantity
Price
June 30th
1
$
184.00
CAD
July 7th
1
$
230.00
CAD
July 14th
1
$
230.00
CAD
July 21st
1
$
230.00
CAD
July 28th
1
$
230.00
CAD
August 5th
1
$
184.00
CAD
August 11th
1
$
230.00
CAD
August 18th
1
$
230.00
CAD
August 25th
1
$
230.00
CAD
Minecraft Education Camp (Early Bird Rate)
$
184.00
CAD
Quantity
Price
June 30th
1
$
184.00
CAD
July 7th
1
$
230.00
CAD
July 14th
1
$
230.00
CAD
July 21st
1
$
230.00
CAD
July 28th
1
$
230.00
CAD
August 5th
1
$
184.00
CAD
August 11th
1
$
230.00
CAD
August 18th
1
$
230.00
CAD
August 25th
1
$
230.00
CAD
Pizza
$
7.00
CAD
Quantity
June 30th
1
2
3
4
5
6
7
8
9
10
July 7th
1
2
3
4
5
6
7
8
9
10
July 14th
1
2
3
4
5
6
7
8
9
10
July 21st
1
2
3
4
5
6
7
8
9
10
July 28th
1
2
3
4
5
6
7
8
9
10
August 5th
1
2
3
4
5
6
7
8
9
10
August 11th
1
2
3
4
5
6
7
8
9
10
August 18th
1
2
3
4
5
6
7
8
9
10
August 25th
1
2
3
4
5
6
7
8
9
10
Primary Coding Camp (Early Bird Rate)
$
184.00
CAD
Quantity
Price
June 30th
1
$
184.00
CAD
July 7th
1
$
230.00
CAD
July 14th
1
$
230.00
CAD
July 21st
1
$
230.00
CAD
July 28th
1
$
230.00
CAD
August 5th
1
$
184.00
CAD
August 11th
1
$
230.00
CAD
August 18th
1
$
230.00
CAD
August 25th
1
$
230.00
CAD
Primary Robotics Camp (Early Bird Rate)
$
184.00
CAD
Quantity
Price
June 30th
1
$
184.00
CAD
July 7th
1
$
230.00
CAD
July 14th
1
$
230.00
CAD
July 21st
1
$
230.00
CAD
July 28th
1
$
230.00
CAD
August 5th
1
$
184.00
CAD
August 11th
1
$
230.00
CAD
August 18th
1
$
230.00
CAD
August 25th
1
$
230.00
CAD
Submit
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