Camp Registration Form

Name:	*
Address:	*
City:
Postal Code:
Phone Number:	*
Email Address:	*
Date of Birth:	*
Emergency Contact:	*
Select a Camp:	1) summer camp #1 Brockville Ages 8-12 2) summer camp #2 Brockville Grades 7-8 3)summer camp #3 Brockville Grades 9-12 4)March Break Camp BR Boys and Girls in Grades 3-8 5)March Break Camp Holy Cross KNG Boys and Girls in Grades 6 7 & 8 1) summer camp #1 Cornwall- Grades 2 - 5 2) summer camp #2 Cornwall- Grades 6 - 10 *
Medical Conditions:	*
Gender:	Male: Female: *
T-Shirt Size:	Small Medium Large Extra Large *
* indicates a manditory field