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 April break, please choose April break for both weeks)
Second Choice (For April break, please choose April break for both weeks)
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.