2019 Summer Camp MAMBO Registration

Camp: *
Regular Hours: 8:30am - 3:30pm
 
After Care Hours: 4pm - 6pm 

Child's Information

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Parent(s)/Guardian(s) Information


Emergency Contact Information

Safe Arrival/Departure Information

Please list the names of individuals who may normally pick up or drop off child. 
Please make a note of someone who should NOT BE allowed to pick up child. 
 
If child does not arrive at camp on scheduled date/time, the primary contact listed on this form will be phoned.

Medical Information

I give consent for my child to receive emergency medical and ambulatory care. I accept that there may be ambulance fees according to hospital regulations. *

Signature

I give my child permission to take part in ALL program related excursions and activities. This includes any scheduled trips/outings (including swimming). *
I give my child permission to be in photos/videos for Eastview Neighborhood Community Centre promotional use. *
Please acknowledge that you are aware that your child is not registered until full payment for week requested is received. * 🛈
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Parent/Guardian Signature: *
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I acknowledge and agree that my child shall use any and all facilities when permitted at his/her own risk. Neither Eastview Neighbourhood Community Centre/East Toronto Family Community Centre or the staff shall be held responsible for any acquired injuries or loss of personal property. I also recognize that the right to participate depends upon the individuals respect for the program, properties, rules, equipment and staff.

Note: Regarding Program Registration Forms: The Personal information on his/her form is collected under the authority of the Community Recreation Centres Act R.S.O. 1990, C22 and Chapter 25, City of Toronto Municipal Code. It will be used by Eastview staff to administer and supervise the program, to obtain care in an emergency and for statistical reports. Questions about this collection may be directed to the Executive Director, Eastview Neighbourhood Community Centre, 86 Blake Street, Toronto, Ontario, M4J 3C9


Registration

Fees: $125/week + $50 ext. care/week

July 2 - July 5
July 8 - July 12
July 15 - July 19
July 22 - July 26
July 29 - August 2
August 6 - August 9
August 12 - August 16
August 19- August 23

Credit Card Information

Signature: *
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