Camp Application
This application has already been submitted. For assistance please contact: registration@kaylaschildrencentre.org
Hidden Fields
Secondary Parent / Guardian ID
Student ID
Primary Parent / Guardian ID
Form ID
Form Status
Program Enrollment ID
Camp Type
Program ID
Camper Information
First Name
Middle Name
Last Name
Preferred Name
Name participant goes by
x
Date of Birth
Format: [12/01/2024]
Gender
Please select...
Male
Female
Current School
Primary Home Address
Address
City
Province
Please select...
AB
BC
MB
NB
NL
NS
NT
NU
ON
PE
QC
SK
YT
Postal Code / Zip Code
Parent/Guardian 1
First Name
Last Name
Email
This email address will receive a copy of the completed form, and be the main point of contact for this Application.
Phone
Please enter a number (without spaces and dashes).
Occupation
Place of Work
Relationship to Child
Please select...
Parent
Guardian
Marital Status
Please select...
Married
Common law
Single
Divorced
Widowed
Separated
Add second Parent / Guardian
Parent/Guardian 2
First Name
Last Name
Email
This email address will receive a copy of the completed form.
Phone
Please enter a number (without spaces and dashes).
Occupation
Place of Work
Marital Status
Please select...
Married
Common law
Widowed
Separated
Divorced
Single
Emergency Contact
Name
Phone
Please enter a number (without spaces and dashes).
Email
Relationship to Child
Select a Program
Which division of Camp18 are you applying for?
Main Division
Adventure Teen Division
Main Division
Main Division Session 1
- Day Camp
5 Weeks (June 30 - July 31)
Main Division Session 2
- Day Camp
2 Weeks (August 4 - 14)
Main Division Bonus Week
- Day Camp
1 Week (August 17 - 21)
Main Division Camp Lionheart
- Overnight Camp
11 Days (August 3-13)
Alert: Main Division Session 2 and Main Division Camp Lionheart run at the same time. Please choose only one.
Adventure Teen Division
Adventure Teen Division Session 1
- Day Camp
5 Weeks (June 30 - July 31)
Adventure Teen Division Session 2
- Day Camp
2 Weeks (August 4 - 14)
Adventure Teen Division Lionheart
- Overnight Camp
9 Days (August 17 - 25)
Additional Information
Please upload a current photo of your child. Only JPEG and PNG files are accepted
What is your child's diagnosis/medical condition? Please note N/A for no diagnosis.
Is your child currently participating in any of the following programs?
Access OAP
SSAH
ACSD
York Region Fee Assistance
Holland Bloorview
JFCS
FHMC
Please indicate the amount of weekly RN/RPN hours
Please indicate the amount of weekly PSW hours
Other
If other was selected, please explain
Credit Card Information
In order to reserve a spot for your child, you will only be charged one deposit fee of
$350
, regardless of how many sessions you apply for. The deposit will be deducted from your total camp fees.
Your credit card will only be charged once your child is accepted into the program. Submitting an application does not guarantee enrolment.
Credit First Name
Credit Last Name
Credit Card Number
Please only enter numbers, no spaces
Expiration Month (e.g. 06)
Expiration Year (e.g. 29)
Security Code (CVV CVC, etc...)
Card Type
Please select...
Visa
Mastercard
American Express
Billing Information
Street
City
State / Province
Postal / Zip Code
Please see our Policies and Procedures
Links to Policies and Procedures
Camp Parent Manual
Therapy Clinic Policies
Fee Schedule
I have read and agreed to the policies and procedures.
Signature
Print out your full name
Date
Today's date. Format: [12/01/2024]