Armour Recreation & Katrine Community Centre Day Camp Program
Program to be ran out of the Katrine Community Centre
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Parent / Guardian Name
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First Name
Last Name
Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
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Please enter a valid phone number.
Email
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example@example.com
Participants Name
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First Name
Last Name
Date of Birth of Participant
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Month
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Day
Year
Date
Emergency Contact #1 Name
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First Name
Last Name
Emergency Contact #1 Phone Number
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Please enter a valid phone number.
Emergency Contact #2 Name
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First Name
Last Name
Emergency Contact #2 Phone Number
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Please enter a valid phone number.
Any medical conditions we should be aware of?
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Does your child need medication during the day? (they must be able to administer themselves) Please specify:
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Please choose all dates you would like to register for (PLEASE NOTE JULY 22 WEEK IS FULL)
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March Break - Mar 8, 11,12,13, 14 & 15
PD Day - Apr 8
PD Day - June 10
July 2 - 5
July 8 - 12
July 15 - 19
July 29 - Aug 2
Aug 6 - 9
Aug 12 - 16
Aug 19 - 23
Aug 26 - 30
Total Owing
I understand that all payments need to be made on time - Please see the rules and regulations for payment terms. (You can choose to pay the remaining balance owing at any time)
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Yes
I would like to apply for subsidy with the District Of Parry Sound Social Services.
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Yes - please call (705) 746-7777 ext. 5277 or e-mail lmurray@psdssab.org
No
This authorization grants permission to use your image (still or moving) and/or your spoken words in perpetuity for educational purposes. By signing this document, you agree: 1.To allow the recording of your image and voice (e.g., photographs, audio, or video).2. To share your image or recording in any medium, be it print or electronic form, which may include the Internet. 3. To grant permission to other entities to reproduce the images or recording for marketing purposes. 4. That there is no reimbursement for the right to take, or to use your photograph or video or recording.
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Yes
No
How will you be paying? ($60 per day)
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E-transfer to info@armourtownship.ca * you MUST put the participants name, your name and e-mail address & "Day Camp" in the message
Township Office (Cash or Cheque)
Signature
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Continue
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