In Service Day Camp Registration

 

 


Do you need more info?  Any special concerns?  Do not hesitate to
call Gabriel at 775-7959, Fax 775-7554

  • Camp times are 8:30AM - 3:30PM
  • Each camp limited to 25 campers
  • Send along bagged lunch (nut free please)
  • We will supply drinks.
  • After care available up to 5PM ($10.00)

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Camp Information:  Dates and Locations 

Feb. 26 / 2010
 Bourkevale CC (St. James) 100 Ferry Rd.

XXXXX/ 2010
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XXXXX / 2010                                                                                  XXXXXXXXXXXXX

   
Camper Information
If you are enrolling multiple children pease register each camper separately!

Camper Name :   Age :  
School Attending :   Grade :   Medical Conditions* :
*Please list any medical and/or other condition that could affect your child during camp. Ex: Allergies, asthma, ADD, etc. 

 

 

My child will walk to and from the camp
My child will be picked up at 3:30 PM
I require after-program care from 3:30PM to 5:00 PM ($10)


Parent/Guardian Information

Name :

Address :
City :  
Email:

Home Phone :
Work Phone :

Emergency Contact :
Emergency Contact Phone :

Registration is based on first received first enrolled; spaces are limited to 25 campers.  Registration is not secured until full payment is received. 

Price Information Here:  $45.00 (aftercare available $10.00)

Cheque or money order payable to "Mad Science of Manitoba" send to:

Mad Science of Manitoba, 1475 Wellington Ave., Winnipeg, MB,  R3E  0K4

Once you click "submit", your registration will be automatically received.  Confirmation of enrollment will be sent by e-mail upon receipt of payment.