Cabaret Kids


Cabaret Kids Summer Camp
2017 Registration

Fill in the form and mail your cheque to:
Cabaret Kids, 3 Northview Place, Dollard Des Ormeaux, Quebec H9B 3K8

 

Camper's Information

 

Campers Name:
E-mail:
Street Address:
City:
Province/State:
Postal Code:
Date of Birth:
Gender:
School:
Grade:
Home Telephone:
Cell phone:
   
Mother's Information
 
Mother's Name:
Cell phone:
Place of work:
Work phone:
   
Father's Information
 
Father's Name:
Cell phone:
Place of work:
Work phone:
   
Secondary Contact Informationn
 
Name:
Relation to camper:
Phone:
Cell phone:
   
Family Information
 
Parents marital status:
Siblings names & ages

(If any)

   
Camp Information

 
Camp hours are
9 AM - 3 PM.
Do you need extended hours?
Yes  No
If yes, what times? (Please add amount to cheques)
Swimming level:
Previous camp experience:
Desired week(s) of attendance:
   
Medical Information
 
Medicare / Health card # and exp. date:
Any activity restrictions:
Family doctor name:
Doctor's  phone:
Appendix operated:
Chicken Pox:
Other:
   
  
Do you give permission to Cabaret to use your child's picture or video in our brochures or web page?(Names are withheld)
Yes  No
Where did you hear about Cabaret Kids?:
 
 
Hot Lunches
 
I am registering for the B.B.Q.
Wednesday $8  Friday $8  Both $16

I have sent in a payment for the B.B.Q $

Do you want kosher hot dog? Yes  No

I am registering for:
Summer Camp Dates: June 26th Aug 18th 2017

Session 1 (2 weeks) June 26th- June 30th/July 3rd - July 7th.

Session 2 (2 weeks) - July 10th July 14th/July 17th -July 21st

Session 3 (2 weeks) - July 24th July 28th /July 31st - Aug. 4th

Session 4 (2 weeks) - Aug. 7th - Aug. 11th/ Aug. 14th - Aug. 18th

Note: show dates are Fridays: July 7th at 1:15pm, July 21st
at 1:15pm, August 4th at 1:15pm, and August 18th at 1:15pm
 


(Please indicate which weeks or sessions)



Tax receipt made out to:
Additional remarks:

Cabaret Kids, 3 Northview Place
Dollard Des Ormeaux, Quebec H9B 3K8