514.808.9053
info@collectivevision.ca

Camp Registration CIT / Regular

PARENT / GUARDIAN INFORMATION

Your Name (required)

Your Email (required)

Confirm e-mail (required)

Street Address (required)

City (required)

Province (required)

Postal Code (required)

Home Telephone (required)

Work Telephone (required* Please write NO for none* )

Cellular (required* Please write NO for none* )

EMERGENCY CONTACT

Emergency Contact Name (required)

Relationship (required)

Emergency Contact Telephone 1 (required)

Emergency Contact Telephone 2 (required* Please write NO for none* )

Emergency Contact Email (required* Please write NO for none* )

CAMPERS' INFORMATION

Child's First & Last name (required)

Age (required)

Medicare , In-case of emergency (required)

Any allergies or medical conditions we should know about? (specify) * Please write NO for none* (required)

As part of the CIT program, attendees are invited to put their newly acquired counselor skills to the test and assist a group in movie making. They may chose one of the sessions to help us lead a group of youth.

Please select you method of payment

TERMS AND CONDITIONS

I give permission to the animators of Creative Video Day Camp to make any decisions regarding the well being of my child(ren). I give permission for my child(ren) to go to the park and pool with the group. I will not hold Coop Collective Vision/Cooperative Creative Video, Concordia University,or the Concordia Student Union responsible for any injuries or for any and all claims of loss and damage to property that may occur. I agree to allow Coop Collective Vision/Cooperative Creative Video to use all pictures and videos across all media platforms, present and future. A registration must be accompanied by a full payment. I understand that there is a 50% cancellation fee which will not be refunded for any reason (ie. illness, change of plans, etc.). The EARLY BIRD DISCOUNT (if any) applies to those who register by the specified dates. Camp hours are 9am-4pm.

Do you agree to the terms and conditions?

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