Week 4: July 19-23 ages 7-9 (P3 & P4)

"*" indicates required fields


Child Information

Gender

Date of Birth*
Home Address

Primary Parent / Guardian Information

This is the Parent/Guardian filling our this form and first point of contact

Secondary Parent / Guardian Information


SPCA Members


Medical

Please provide detailed health information about your child so that we can provide the highest level of care:

Permissions

I give permission for my child to swim/wade at SPCA camp*
Their swimming ability is:*

Media Release
Liability*
Camp Cancellation Policy*

Week 4: July 19-23 ages 7-9 (P3 & P4)

Billing Info

Address*

Credit Card Info

Credit Card*
MasterCard
Visa
Supported Credit Cards: MasterCard, Visa