Summer Camp Registration

Child's Last Name

Child's First Name

Date of Birth (Please use 0000-00-00 format, yr-mo-da, all others will NOT work)

Health Card Number

Current Grade

Street Address

City

Postal Code

Home Phone Number

Family Email Address

Will you be requiring Before and After Care?
YesNo
If Before and After is required what days and times (**also if there is a different person picking up a password and ID are needed**).

Mother's Full Name

If information is different than above then please fill out.
Mother's Street Address

Mother's City

Mother's Postal Code

Mother's Home Phone Number

Mother's Work Phone Number

Mother's Cellular Number

Father's Full Name

If information is different than above then please fill out.
Father's Street Address

Father's City

Father's Postal Code

Father's Home Phone Number

Father's Work Phone Number

Father's Cellular Number

Child's Doctor's Name

Child's Doctor's Phone

Medical Information (please include allergies and other pertinent information)

Emergency Contact #

Emergency Contact Name

Please check the theme weeks to sign up for the weeks you are most interested in. Our themes and weeks change each year so make sure you check the website information.
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July 2-5 -- Viking WeekJuly 8-12 -- Science WeekJuly 15-19 -- Cooking WeekJuly 22-26 -- Dinosaur Week

July 29-Aug 2 -- Rocketry WeekAug 6-9 -- Sports WeekAug 12-16 -- Cooking Week 2Aug 19-23 -- Survivor Week
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***With the enrolling of my child at Hillcrest Private School Summer Camp a $50 deposit for each week enrolled is required to finalize the registration and hold your child(s) spot. There are ONLY 40 spots available for each week!!***
Permission
Any expenses incurred for any kind of medical attention, will be borne by the child's family. Hillcrest will not be responsible for anything that may happen as a result of false information given at the time of enrollment.
I hereby grant permission for my child to use all of the play equipment and participate in all the activities of the Summer Day Camp.
I hereby grant permission for my child to leave the Hillcrest premises under the supervision of a staff member for neighbourhood walks or for field trips in an authorized vehicle.
I hereby grant permission for my child to be included in all games and activities with all the other children and will not hold the Hillcrest responsible for any injuries that may occur from these activities.
I hereby grant permission for the person in charge that day to take whatever steps may be necessary to obtain emergency medical care if warranted.
If we cannot contact you or your child's physician we will do any or all of the following: 1) Call another physician or paramedics. 2) Call an ambulance. 3) Have the child taken to an emergency hospital in the company of a staff member.
PLEASE READ CAREFULLY
**With the enrolling of my child at Hillcrest Private School Summer Camp, I will pay a $50 deposit for each week my child is enrolled and fulfill my financial obligation so my child is allowed to participate in the Hillcrest Summer Day Camp.
There is a 2% interest charge on all outstanding account balances and a $35 service charge for any returned cheques. Families who have outstanding balances will be asked to leave the Summer Day Camp and will not return until their accounts are in good standing.

I agree to the above statements
*Form will NOT submit unless you click box to agree*