Summer Camp 2012 Submission Form

Camp Rates 2012 $330.00/week + HST

Please complete the form as much as possible and click on submit when done. A confirmation E-mail will be sent within a couple of days.

If you require more info call or E-mail us.

Please identify and describe yourself:

First Name
Last Name
Age
Sex	Male Female
Street Address
City
Postal Code
E-Mail
Work Phone
Home Phone

Choose one of the following options:

Camp Week 1             Full
Camp Week 2             July (16th-20th)
Camp Week 3             July (23rd-27th)
Camp Week 4             August (13th-17th)
Camp Week 5             August (20th-24th)
Camp Week 6             August (27th-31st)

Check here if you require extended care hours- offered at $15.00/day + HST

   Extended care (8:00am drop off 5:30pm pick-up)



Please enter any medical conditions or special precautions necessary.

Please enter Emergency contact information

Author information goes here.
Copyright © 2011 [Schellenberg Stables]. All rights reserved.
Revised: 02/06/12