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.). Camp hours are 9am-4pm.

Do you agree to the terms and conditions?

How did you hear about us? (required)