Parental Information

FATHER'S INFORMATION

First Name

Last Name

Employer

Work Phone

Cell Phone

Lives with child(ren)

Yes

MOTHER'S INFORMATION

First Name

Last Name

Employer

Work Phone

Cell Phone

Lives with child(ren)

Yes

Contact Information

HOME ADDRESS

Street Address

City/Town

Province

Postal Code

MAILING ADDRESS (only if different from home address)

PO Box Number

City/Town

Province

Postal Code

CONTACT

Home Phone

Primary Email

EMERGENCY CONTACT

In the event of an emergency, and we are not able to contact you, who should we contact

Frist Name

Last Name

Relationship to child

Home Phone

Cell Phone

Permissions

EVENTS OFF SCHOOL PROPERTY

I give permission for my child to take part in all activities, camp sponsored trips away from the school’s premises. I absolve Sussex Christian School from liability to me or my child because of any injury to my child at school or during any school activity.

Yes

PHOTO PUBLISHING

I give permission for my child’s photo to be published in print media.

Yes

I give permission for my child’s photo to be published in video media (for such things as school dramas, etc.)

Yes

I give permission for my child’s photo to be published on school website and/ or Social Media pages.

Yes

How Did You Learn About This Camp?

How did you learn about the Pre-School Summer Day Camp

A friend told me

Saw the newspaper ad

School website

Other

Parental Signature

By selecting the "I Accept" button, you are signing this form electronically. You agree your electronic signature is the legal equivalent of your manual signature on this form. By selecting "I Accept" you consent to be legally bound by content, terms and conditions of this form.

I Accept

First Name

Last Name

Date

Your email

Pre-School Summer Day Camp Registration

FIRST CHILD

SECOND CHILD

THIRD CHILD

FAMILY PHYSICIAN

EMERGENCY MEDICAL TREATMENT

Parental Information

FATHER'S INFORMATION

MOTHER'S INFORMATION

Contact Information

HOME ADDRESS

MAILING ADDRESS (only if different from home address)

CONTACT

EMERGENCY CONTACT

Permissions

EVENTS OFF SCHOOL PROPERTY

PHOTO PUBLISHING

How Did You Learn About This Camp?

Parental Signature

Contact Us

Affiliations & Associations