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Summer Camp Registration Form
               Camp Hours: 9:00 a.m. – 4: 00 p.m. @ $200.00 per week

Name of child________________________________ Sex____ Date of Birth__________________

Father’s Name & Address___________________________________________________________
________________________________________________________________________________
Father’s Phone# (H) ___________________ (W) ___________________Cell___________________
Mother’s Name Address _____________________________________________________________
________________________________________________________________________________
Mother’s Phone # (H) __________________ (W) ___________________Cell___________________
Health Card #     _______________________
Physician Name __________________________ Phone#____________________________________
Emergency Contact:
Name __________________________________Phone#___________________
Name __________________________________Phone#___________________

My child will attend:
Jul 2nd – Jul 5th ________             Jul 29th –Aug 2nd ______
Jul 8th – Jul 12th ______               Aug 6th – Aug 9th _____
Jul 15th – Jul 19th ______             Aug 12th – Aug 16th _____
Jul 22nd – Jul 26th _______             Aug 19th – Aug 23rd _____

    •   Snacks & Lunch included
    •   Fully supervised by our qualified staff
    •   For children ages 3-9 years
    •   Child safety is our first priority
    •   Payment of fees due upon registration
    •   Before & After Care available for $30.00
    •   Field Trip Cost Extra



    Space is limited.
    Registration is accepted on a first come first serve
    basis
       No cancellations or refund
For more information please call 905 - 569 - 1000

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Register you child in montessori works 2013 summer camp

  • 1. Summer Camp Registration Form Camp Hours: 9:00 a.m. – 4: 00 p.m. @ $200.00 per week Name of child________________________________ Sex____ Date of Birth__________________ Father’s Name & Address___________________________________________________________ ________________________________________________________________________________ Father’s Phone# (H) ___________________ (W) ___________________Cell___________________ Mother’s Name Address _____________________________________________________________ ________________________________________________________________________________ Mother’s Phone # (H) __________________ (W) ___________________Cell___________________ Health Card # _______________________ Physician Name __________________________ Phone#____________________________________ Emergency Contact: Name __________________________________Phone#___________________ Name __________________________________Phone#___________________ My child will attend: Jul 2nd – Jul 5th ________ Jul 29th –Aug 2nd ______ Jul 8th – Jul 12th ______ Aug 6th – Aug 9th _____ Jul 15th – Jul 19th ______ Aug 12th – Aug 16th _____ Jul 22nd – Jul 26th _______ Aug 19th – Aug 23rd _____ • Snacks & Lunch included • Fully supervised by our qualified staff • For children ages 3-9 years • Child safety is our first priority • Payment of fees due upon registration • Before & After Care available for $30.00 • Field Trip Cost Extra Space is limited. Registration is accepted on a first come first serve basis No cancellations or refund
  • 2. For more information please call 905 - 569 - 1000