Innovations Enrollment Form .pdf

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Original filename: Innovations Enrollment Form.pdf
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Enrollment Form

Camp Location:
80 Acorn Place #16
Mississauga, ON, L4Z 4C9
Emergency Contacts
Name: ______________________________________________________________
Date of Birth: ________________________________________________________
Grade (entering in September): _____________________
Allergies: ____________________________________________________________
Health Card Number: _________________________________________________
Pick up permission give to: _____________________________________________
Emergency Contacts
Contact #1
Name: _________________________ Phone Number: ________________________
Relation to the Child: ___________________________________________________
Contact #2
Name: _________________________ Phone Number: ________________________
Relation to the Child: ___________________________________________________


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