Summer Youth Recreation Program 2024

Summer Youth Recreation Program 2024
Parent or Guardian Name*

First NameLast Name
E-mail*
example@example.com
Phone
Emergency Contact Name*

First NameLast Name
Emergency Contact Number*
Please enter a valid phone number.
Student 1 Name*

First NameLast Name
Birth Date

MonthDayYear
Gender
Family Doctor
BC Care Card #
Allergies/ Medical Conditions
Please Select all Courses for Student 1

Intro to Documentary Filmmaking with Jennifer $90Eco Skills with Autumn $80Cortes Junior Guard with Sadie $160Fairy World with Claudia and Monika $45Circus Play with Coco & Jamie $60Soccer with John & David $45Nature Play with Claudia $30Fort-Building $30 (full but waitlist being taken)Radio Gaga $60 (full but waitlist being taken)
Cortes Corners $60 ($20 per day)

Tuesday - Wetland at 1642 Carrington Bay Rd.Wednesday - Kwaas Bay Rd. parking lotThursday - Mansons Lagoon
Swimming Lessons with Sadie $60

Level 1Level 2Level 3 (full but waitlist being taken)Level 4Level 5Level 6Basic swimming skills for non-swimmers age 10+
Action Games with Claudia $60 ($15 per session). Please specify either full program, or individual dates: July 15, 22; August 5, 12, 19
Horse Play with Oriane Lee Johnston $45
Jump into Music! with Monica Lee $60
Add another learner?

Yes

~Please note current SCCA Membership is required for registration~
PAY BY E-TRANSFER to "admin@mansonshall.org"

Please use the password "cortes" and in the NOTES Section please write the names of the children registered.
Want to be invoiced? Email: "admin@mansonshall.org"
Additional Comments and Information:
Should be Empty:

PAY BY E-TRANSFER to "admin@mansonshall.org"