Welcome to Liliput Summer Camps!

Tell us about your Camper
Camper Information
Child Name*

First NameLast Name
Date of Birth

MonthDayYear
Age:

{age}
Age
Need Assistance Using the Washroom?

NoYes
Describe what kind of Assistance needed
Leave Blank if there is None
Any History of Communicable Disease
Leave Blank if there is None
Any Food Allergies
Leave Blank if there is None
Any Medical Disease or Situation
Leave Blank if there is None
Any Emotional Matter we should know
Leave Blank if there is None
Parent/Guardian Information
Name

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Secondary Contact (Emergency)
Name

First NameLast Name
Phone Number
Please enter a valid phone number.
Relationship
Authorized People to Pick-up Child

Parent/GuardianSecondary ContactOther

Other Pickup People

Checkout

Order Summary

Original Amount	${originalAmount}
for {selectedWeeks} Week Registration
Befor/After Care	${beforeampamp}
Discounts	${discounts}
Early Bird (${earlyBird})
Multi-Week (${multiWeek})
{multiWeek100}
Subtotal	${subtotal}
HST	${hst}
Order Total	${orderTotal}

Payment Type
${deposit32} Due Now

${later} due on June 15, 2025

You will receive a Pay Link asking for the remaining balance by email. Please keep an eye out for it in early June. We do not store your payment information on file, and we will not charge your card directly.

Due Now

CADDescription

Credit Card
First Name	Last Name
Credit Card Number	Security Code
Expiration Month	Expiration Year

Should be Empty: