Summer Camp 2024 Form

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4 weeks July 8 to August 2nd

Mon-Fri 9:00 am to 3:30 pm

*After camp program available for extra fees, contact us for more details

**Drop off time starts at 8:30am

Email *

Participant's Full Name *

Mother's Name *

Father's Name *

Email Address *

Parent Phone Number *

Emergency Contact Name *

Emergency Contact Phone Number *

Which Age Group is Your Child In? *

6-9 Years Old (YOB: 2015-2018) Boys & Girls

10-13 Years Old (10-13y/YOB: 2011 to 2014) **GIRLS ONLY**

Year Of Birth *

Any Allergies or Medical Concerns? (if yes, remedy? ) *

I understand that I will have the pay the FULL payment by June 1st or upon completing this registration form if filled after June 1st. ( Spots are very limited and payment is required to secure your child's spot! )
*

Yes

Required

Refund Policy

$50 Admin Fee is non-refundable

I agree that,

If full payment is received and a written cancellation request is received before June 8 then the full amount ( not including $50 admin fee) will be refunded.

If written cancellation request is received before July 5 half amount ( not including $50 admin fee) will be refunded

No refunds are issued after July 5th

Yes, I agree to this

Required

To Finalize Your Registration A Payment Is Required (preferably by e-transfer, cheque or cash), choose an option: *

By E-Transfer

By Cash, Debit or Cheque IN CENTER during office hours

Agreement to Conditions

I, agree and understand that my child, named above, has my permission to participate in the program/activities/trips

By signing this agreement, my child and I understand that my child will be assuming injury and certain legal risks. I, as the Parent or Legal Guardian of the child, confirm that I understand and agree to the conditions contained in this Agreement and in the Enrolment Form prior to signing them.

I agree

Required

Agreement of Program Activities/Field Trips

I understand that my child will be participating in weekly fieldtrips.

Please note all parents will be informed a day before each field trip.

I agree

Required

Student Photo Release Report:
Photos, videos, films or interviews will only be done with the prior knowledge and consent of the school principal or designate and will not be used for commercial gain.
I/we hereby consent to the inclusion of photographs of my/our child in the following:
• class pictures, yearbook, special events/awards, videos and films
• photographers, films, or interviews taken by media as part of a school-related activity
• school board publications produced by the Communications Department
• photographs for use on school Internet pages and our public web sites

I/We hereby consent to the inclusion of any photographs of my/our child

I/We hereby DO NOT consent to the inclusion of any photographs of my/our child

Summer Camp 2024 Registration Terms and Conditions
*

I have read and understood the Izzah Learning Center's Terms And Conditions

Required

Signature Agreeing to Izzah Learning Center's Terms And Conditions
*

Comments or Concerns

A copy of your responses will be emailed to the address you provided.

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