Dear Parent/Guardian, Please complete and submit this form by the first day of camp. 1 General Information 2 Medical Information 3 Complete Child's Information Child's First Name Child's Last Name Home Phone Number Birthdate Address Address 2 City/Town Province - Select -AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Postal Code Camp - Select -March Musical - The Pied Piper of Hamelin! (Ages 8-10)Instrument Exploration Camp (Ages 4-5)Instrument Exploration Camp (Ages 6-7) Parent/Guardian Contact Information #1 Parent/Guardian First and Last Name Parent/Guardian Email Home Phone Number Cell Phone Number #2 Parent/Guardian First and Last Name Parent/Guardian Email Home Phone Number Cell Phone Number Pick-Up List / Alternative Emergency Contact #1 Name Phone Number Relationship to Child #2 Name Phone Number Relationship to Child Only the people listed on your pick-up information on the above list, and those listed under Parent/Guardian, will be permitted to pick your child up from camp. Any changes to this information must be submitted in writing to the program leader. Photo identification may be required. Parent/Guardian Consent to Sign In/Out I give permission for my child to sign in alone at the scheduled time. - Select -YesNo I give permission for my child to sign out alone at the scheduled time. - Select -YesNo Parent/Guardian Signature The camp day ends at 4:00pm. If your child has enrolled in Extended Care, please pick them up by 6:00pm. Please acknowledge by providing your signature below: Please remember that your child has spent a long, action-packed day at camp. It is important that children are picked up as early as possible at the end of the day for their own well-being.