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2014 Learn-2-Ride Camp Camper Information Camper Name: _____________________________ Sex (circle): M

F

Birthdate (DD/MM/YYYY): ________

Street Address: _____________________________________________ Home Phone: _____________________ City: _________________________ Provence: ____________________ Postal Code: ______________________ Contact Information Parent/Legal Guardian Name: _________________________________ Cell Phone: _______________________ Email for Communication & Confirmation: ________________________________________________________ Emergency/Medical Information Allergies/Medical Limitations: __________________________________________________________________ Emergency Contact Name: ____________________________________________________________________ Relationship to Camper: _______________________________ Phone Number: _________________________ Camp Sessions Week 1: July 21-25

$100/week

Week 2: July 28-August 1

$100/week

T-shirt size: (youth/adult S, M, L)__________

Options Bike rental

$20/week

Limited bike rentals available. Bringing a bike is highly recomended.

Early Drop-Off

$50/week

Early Drop-Off is considered anythime before 8:30am.

Late Pick-Up

$50/week

Late Pick-Up is considered anytime after 4:00pm.

Payment Cash

Cheque

Total (Camp cost + Options): ______________________________ Important Notes Helmets are MANDATORY for camp sessions. Signed waiver forms are required for all participants. Registration To register, send or bring this completed form along with full payment (and parent signed waivers) to the Youth Unlimited Office at Spring Garden Church: Spring Garden Church 112 Spring Garden Ave. Toronto ON M2N 3G3 Contact:

Jesse James

647- 835 - 8062

jesse@youthunlimitedgta.com


Camp form