Camps at The Manor Registration Form

Summer Camp Registration
Camper's Information
Last Name*
First Name*
Middle Name
Gender*

MaleFemalePrefer Not To Identify
Address*
City*
Province*
Postal Code*
Birth Date*

MonthDayYear
Grade entering in the fall*
Camp Fees:
- 5-Day Week - $250
- *4-Day Week - $200

Please select your camp week(s) and type of camp(s)*

	Adventure Camp	Multi-Sport Camp	Soccer Camp
*Week 1: July 2-5
Week 2: July 8-12
Week 3: July 15-19
Week 4: July 22-26
Week 5: July 29 - August 2
*Week 6: August 6-9
Week 7: August 12-16
Week 8: August 19-23
Week 9: August 26-30

Camp Options:
- Meal Plan - $45
- Before Care - $40
- After Care - $50
- Before & After Care - $75
NOTE: Options for Weeks 1 & 6 are pro-rated due to the shorter weeks.

Please select your camp option(s)

	Meal Plan	Before Care	After Care	Before & After Care
Week 1: July 2-5
Week 2: July 8-12
Week 3: July 15-19
Week 4: July 22-26
Week 5: July 29 - August 2
Week 6: August 6-9
Week 7: August 12-16
Week 8: August 19-23
Week 9: August 26-30

Is there any other information you'd like to provide us about the camper?
Do you have another child you'd like to register?*

YesNo
Camper #2 Information
Last Name*
First Name*
Middle Name
Gender*

MaleFemalePrefer Not To Identify
Is the address of Camper #2 the same as Camper #1?*

YesNo
Address*
City*
Province*
Postal Code*
Birth Date*

MonthDayYear
Grade entering in the fall*

Is there any other information you'd like to provide us about the camper?
Parent or Legal Guardian Information
Parent/Legal Guardian 1*
Relationship with Child*
Work Phone*

Area CodePhone Number
Cell Phone

Area CodePhone Number
Home Phone*

Area CodePhone Number
Parent /Legal Guardian 2
Relation with Child
Work Phone

Area CodePhone Number
Cell Phone

Area CodePhone Number
Home Phone

Area CodePhone Number
Parent or Legal Guardian Information - Camper #2
Is the Parent/Legal Guardian information for Camper #2 same as Camper #1?*

YesNo
Parent/Legal Guardian 1*
Relationship with Child*
Work Phone*

Area CodePhone Number
Cell Phone

Area CodePhone Number
Home Phone*

Area CodePhone Number
Parent /Legal Guardian 2
Relation with Child
Work Phone

Area CodePhone Number
Cell Phone

Area CodePhone Number
Home Phone

Area CodePhone Number
Emergency Contact Info
Emergency Contact Name #1 (if parent or guardian is not available)*
Emergency Work Phone Number

Area CodePhone Number
Emergency Cell Phone Number*

Area CodePhone Number
Emergency Home Phone Number

Area CodePhone Number
Emergency Contact Name #2 (if parent or guardian is not available)
Emergency Work Phone Number

Area CodePhone Number
Emergency Cell Phone Number

Area CodePhone Number
Emergency Home Phone Number

Area CodePhone Number
Emergency Contact Info - Camper #2
Is the Emergency Contact information for Camper #2 same as Camper #1?*

YesNo
Emergency Contact Name #1 (if parent or guardian is not available)*
Emergency Work Phone Number

Area CodePhone Number
Emergency Cell Phone Number*

Area CodePhone Number
Emergency Home Phone Number

Area CodePhone Number
Emergency Contact Name #2 (if parent or guardian is not available)
Emergency Work Phone Number

Area CodePhone Number
Emergency Cell Phone Number

Area CodePhone Number
Emergency Home Phone Number

Area CodePhone Number
Authorized Pick-Up Info

NOTE: Valid ID must be presented that matches identically to the info provided below. Please select up to three (3) authorized individuals below.
Select from the list below or indicate the individual's information below.*

Parent/Legal Guardian 1 (Indicated Above)Parent/Legal Guardian 2 (Indicated Above)Emergency Contact 1 (Indicated Above)Emergency Contact 2 (Indicated Above)Other (Indicate Below)
Authorized Pick-Up #1 Full Name (If not listed above)
Authorized Pick-Up #1 Relation with Child
Authorized Pick-Up #2 Full Name (If not listed above)
Authorized Pick-Up #2 Relation with Child
Other info our counsellors may need to be aware of regarding authorized pick-up:
Authorized Pick-Up Info - Camper #2

NOTE: Valid ID must be presented that matches identically to the info provided below. Please select up to three (3) authorized individuals below.
Is the Authorized Pick-Up information for Camper #2 same as Camper #1?*

YesNo
Select from the list below or indicate the individual's information below.*

Parent/Legal Guardian 1 (Indicated Above)Parent/Legal Guardian 2 (Indicated Above)Emergency Contact 1 (Indicated Above)Emergency Contact 2 (Indicated Above)Other (Indicate Below)
Authorized Pick-Up #1 Full Name (If not listed above)
Authorized Pick-Up #1 Relation with Child
Authorized Pick-Up #2 Full Name (If not listed above)
Authorized Pick-Up #2 Relation with Child
Other info our counsellors may need to be aware of regarding authorized pick-up:
Health Information
Are immunizations up to date?*

YesNo
Any activity the camper should be restricted from?*

YesNo
If yes, please describe.
Any physical, mental or other condition that would require special attention or medication while at camp?*

YesNo
If yes, please describe.
Will you be providing the camp with any medications for your camper(s), both prescribed and over the counter, all medications will be turned into the Camp Nurse except rescue inhalers?*

YesNo
If yes, please describe.
Does your child have any allergies?*

YesNo
If yes, please describe.
Does your child have any dietary needs that we should know about?*

YesNo
If yes, please describe.
Health Information - Camper #2
Are immunizations up to date?*

YesNo
Any activity the camper should be restricted from?*

YesNo
If yes, please describe.
Any physical, mental or other condition that would require special attention or medication while at camp?*

YesNo
If yes, please describe.
Will you be providing the camp with any medications for your camper(s), both prescribed and over the counter, all medications will be turned into the Camp Nurse except rescue inhalers?*

YesNo
If yes, please describe.
Does your child have any allergies?*

YesNo
If yes, please describe.
Does your child have any dietary needs that we should know about?*

YesNo
If yes, please describe.
Camper Photo Release
I agree that photos of the camper(s) registered can be taken and used for camp social media purposes*

YesNo
Email Confirmation
Parents Email (camper confirmation will be sent by email)*
Other Information
How did you hear about Camps at The Manor?
First Time Camper?*

YesNo
First Time Camper? - Child #2*

YesNo
Parent Confirmation
By hitting submit and putting your initials, you agree that you are the parent or legal guardian of the above named camper, and are over the age of 18. In case of medical emergency or general medical care, I give consent for medical teatment for the aboved named camper by authorized personnel. The camp carries secondary insurance. I understand that the above named camper will only be released to the names listed above, an update may be done at registration. I certify that my child has my permission to attend camp and participate in all activites.
Electronic signature, please initial*
Payment Information

Select the number of weeks and options you are signing up for your entire order. For example: If you are registering two campers for two weeks each, you would choose "4 weeks" for your options below. A final invoice for payment indicating a break-down of your registration costs will be emailed to you within one (1) business day. Once payment is made, your registration will be confirmed.
Payment Information

The total cost of your registration is calculated below. The final cost below includes taxes and a one-time $25.00 registration fee. A final invoice for payment indicating a break-down of your registration costs will be emailed to you within one (1) business day. If you've entered a promo code below, the promo code will be reflected on your invoice.
Total cost

Select your entire order below.*

Camp Registration$250.00CAD

NUMBER OF WEEKS

*Camp Registration (4-DAYS - WEEK 1 & 6)$200.00CAD

NUMBER OF WEEKS

Meal Plan$45.00CAD

NUMBER OF WEEKS

*Meal Plan (4-DAYS - WEEK 1 & 6)$36.00CAD

NUMBER OF WEEKS

Before Care (7:30 a.m. to 9 a.m.)$40.00CAD

NUMBER OF WEEKS

After Care (4 p.m. to 5:30 p.m.)$50.00CAD

NUMBER OF WEEKS

Before & After Care$75.00CAD

NUMBER OF WEEKS

Enter coupon

Subtotal $0.00CADShipping $0.00CADTotal $0.00CAD

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Summer Camp Registration

Camper's Information

Camper #2 Information

Parent or Legal Guardian Information

Parent or Legal Guardian Information - Camper #2

Emergency Contact Info

Emergency Contact Info - Camper #2

Authorized Pick-Up Info

Authorized Pick-Up Info - Camper #2

Health Information

Health Information - Camper #2

Camper Photo Release

Email Confirmation

Other Information

Parent Confirmation

Payment Information

Payment Information