Glendale Farms Summer Day Camp And March Break Camp Form
March Break / Summer Day Camp
COVID-19 NOTICE:
With the changes to COVID-19 restrictions that the government has put in place, all participants must have a filled Self Health Declaration Form. This form will be sent with the admission package and must be filled a day prior to your child attending camp.
Name
First
Last
Age
Date of Birth
/
MM
/
DD
YYYY
Gender
Male
Female
Address
City
Province
Postal Code
Email
Mother's Name
First
Last
Home Phone
-
(###)
-
###
####
Work Phone
-
(###)
-
###
####
Father's Name
First
Last
Home Phone
-
(###)
-
###
####
Work Phone
-
(###)
-
###
####
Emergency Contact
Home Phone
-
(###)
-
###
####
Returning Camper
Yes
No
Other Contact
Relationship
Phone
-
(###)
-
###
####
Doctor's Name
Phone
-
(###)
-
###
####
Health Card #
Allergies/Physical Disabilities/Other Information
Week Requested (For March break, please choose March break for both weeks)
March Break - March 14 - 18 2022
July 11 - July 9 2022
July 18 - July 22 2022
July 25 - July 29 2022
August 1 - August 5 2022
August 8 - August 12 2022
August 15 - August 19 2022
August 22 - August 26 2022
August 29 - September 2 2022
Second Choice (For March break, please choose March break for both weeks)
March Break - March 14 - 18 2022
July 11 - July 9 2022
July 18 - July 22 2022
July 25 - July 29 2022
August 1 - August 5 2022
August 8 - August 12 2022
August 15 - August 19 2022
August 22 - August 26 2022
August 29 - September 2 2022
Horse Knowledge
COVID-19 NOTICE:
With the changes to COVID-19 restrictions that the government has put in place, all participants must have a filled Self Health Declaration Form. This form will be sent with the admission package and must be filled a day prior to your child attending camp.