ROAD TRIP SUMMER CAMP REGISTRATION – WYNCHEMNA

ESL SUMMER CAMP 2019

    STUDENT INFORMATION
    Name of Student (exactly as passport)(*)

    Please be sure the name you enter here is the student's exact name as it is shown in his or her passport.
    Gender(*)
    BoyGirl
    Date of Birth(*)
    / /
    Special Information

    Please provide any details about your child that we should know about - allergies, disabilities, medications, or other important information.
    Current School
    How did you hear about us?
    PARENT INFORMATION
    Parent or Guardian Full Name(*)
    Parent/Guardian Address(*)

    Please enter your full mailing address. This might be required for a visa if required.
    Parent/Guardian Job Title

    This might be required for visa purposes if required.
    Parent/Guardian Employer

    This might be required for visa purposes.
    Home Phone(*)
    Mobile/Cell Phone
    Email(*)
    COURSE REGISTRATION INFORMATION
    My child wants to register for the following course(*)
    5 week - Calgary July 4 to Vancouver August 74 week - Calgary July 11 to Vancouver August 7
    My child wants instruction in:(*)
    EnglishEnglish and French
    How many years has your child studied English(*)
    How many years has your child studied French?
    Child's swimming ability(*)
    Non-SwimmerBeginner SwimmerStrong Swimmer
    I understand that Wynchemna reserves the right to cancel or modify any programme or programmes listed in the brochure because of an insufficient number of participants or for any other reason beyond its control. In such a case, written notification of cancellation will be sent out and the fees will be refunded.(*)
    Yes
    I understand that Wynchemna reserves the right to withdraw participants whose behavior is likely to affect the smooth operation of the programme or adversely affect the enjoyment or safety of other participants. Wynchemna will be under no liability to such persons. If a child has to be sent home on disciplinary grounds, the parents will be required to pay for any costs incurred.(*)
    Yes
    SOME OF THE ACTIVITIES LISTED IN THE BROCHURE (FOR EXAMPLE, ROCK CLIMBING) REQUIRE AN ADULT TO SIGN LIABILITY WAIVER-FORMS.
    I give permission to the Wynchemna Instructor to sign a waiver-form for my child.(*)
    Yes
    I understand and permit that my child may have his or her photograph taken, and that these photographs may be used for advertising or other purposes by Wynchemna (for example, in brochures or on its website).
    Yes

    WYNCHEMNA CALGARY SUMMER CAMP INFO

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