PROGRAM REGISTRATION

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First Name
Last Name
Address
City
Province
Postal Code
Primary Telephone No.
School
Grade as of June 15
Relevant Medical Information
Parent/Guardian:
Telephone:
Emergency Contact:
Telephone:
How will your child depart from camp?

If your child has allergies and requires emergency treatment (puffer, epi-pen, etc.) please ensure that  the child arrives with this item, is trained on how to use their device and is trained on how to seek  assistance in a medical crisis. It is also your responsibility to ensure that staff is aware of this need and is  aware of the emergency procedure. In the event of a medical crisis, 911 will be called for treatment.  


Every effort will be made to provide a safe environment while your child is at the Malton STEM Camp.  Attendance will be taken several times throughout the day and we ask that you notify the staff of any  change to your child’s arrival and departure. 


On special outing, I give permission for …………N/A …….… to be transported by: 

(Please check all that apply) BUS PUBLIC TRANSPORT WALKING 

Parent/Guardian Signature
Date
Malton STEM Camp 2023
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