Winter Camp 2025

Winter Camp 2025
Personal Information
Name*

First NameLast Name
Date of Birth*

MonthDayYear
Gender*

MaleFemale
Nationality*
Passport*
Are you currently in Canada?*

YesNo
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Contact Information
Email*
example@example.com
Phone Number*

Area CodePhone Number
Emergency Contact Name*
Emergency Contact Phone*
Emergency Contact Email
Emergency Contact Relationship
Program Information
Camp Start Date*

December 9, 2024December 16, 2024December 23, 2024December 30, 2024January 6, 2025January 13, 2025January 20, 2025
Camp Length*

2 weeks3 weeks4 weeks
Camp Length*

2 weeks3 weeks
Camp Length*

2 weeks
Medical Information
Do you have any allergies?*

YesNo
List Allergies
Do you have any medical issues?*

YesNo
List Medical Issues
Do you have any physical disabilities?*

YesNo
List Physical Disabilities
Do you have any food restrictions?*

YesNo
List Food Restrictions
Are you allergic to pets*

YesNo
Specify which pet(s)
Do you smoke?*

YesNo
List any other issues
Should be Empty:

Personal Information