CAMP REGISTRATION
What is your full-name?
*
First Name
Last Name
What is your email address?
*
example@example.com
What is your phone number?
*
-
Area Code
Phone Number
What is your child's name?
*
First Name
Last Name
Would you like to reserve your spot right now for only $25?
*
Yes
No
What summer camp would you like to reserve your spot for?
*
Week 4 - Mobile App Development - August 7th to 10th
What summer camp would you like to register your child for?
*
Week 4 - Mobile App Development - August 7th to 10th
What After Hour Care option would you like?
8:00 AM - 9:00 AM
4:00 PM - 5:00 PM
8:00 AM - 9:00 AM & 4:00 PM - 5:00 PM
None
Your total
*
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next
( X )
CAD
Credit Card Details
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
How old is your child?
*
Calculation
What is the name of an emergency contact?
*
First Name
Last Name
Does your child have any allergies?
*
Yes
No
Type your child's allergies here
Does your child have any other medical conditions we should know about?
*
Yes
No
Type your child's medical conditions here
What is your emergency contact's phone number?
*
-
Area Code
Phone Number
REGISTER
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