Single Day (or PD Day) Art Camp Registration Which date(s) are you requesting? Please note verification of space must be made with Get Messy prior to registration- no exceptions.1st Parent's Full Name(Required) First Last 1st Parent's Phone Number(Required)Email(Required) Enter Email Confirm Email Correspondence will be sent to this email so please make sure the email you provide is one that is monitored regularly.2nd Parent's Full Name First Last 2nd Parent's Phone NumberHow many children do you wish to register?(Required) 1 Child 2 ChildrenInformation for 1st ChildChild's Name(Required)Date of Birth(Required) Year Month Day MCP Number(Required)Does this child require any additional supports (ie. are there any medical, physical, or behavioural concerns our staff should be aware of?)(Required)Does this child have any allergies?(Required)Does your child avail of a student assistant at school? (in any capacity - not necessarily 1:1)(Required) Yes NoInformation for 2nd ChildChild's Name(Required)Date of Birth(Required) Year Month Day MCP Number(Required)Does this child require any additional supports (ie. are there any medical, physical, or behavioural concerns our staff should be aware of?)(Required)Does this child have any allergies?(Required)Does your child avail of a student assistant at school? (in any capacity - not necessarily 1:1)(Required) Yes NoAdditional InformationEmergency Contact Name(Required)This person must be someone OTHER than the parents listed aboveEmergency Contact's Phone Number:(Required)Additional people besides parents listed above who can pick up child and relationshipAny special requests for cohort grouping? If none, please respond N/A.Digital signature required: I hereby declare that the above information is correct. Please type your name in the section below to confirm.PaymentHow many children are you registering for this single day / PD Day camp? (ex: 1 child x 1 day= put 1 in the box below, 1 child x 2 days = 2 in the box below, 2 children x 1 day = 2 in the box below) Quantity(Required) Price: $ 65.00 CAD Quantity 30 spaces available.This number will be used to calculate your total registration price.Total Credit CardCardholder Name Card DetailsUntitledCommentsThis field is for validation purposes and should be left unchanged.
