The Wilds - Co-Ed Registration 2021

1 Camper / Contact 2 Options and Fees 3 Payment 4 Complete

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Contact Information

Email *

Please enter the email that you would like Camp Communications (Camp Confirmation, Parent Handbook, Events, etc.)

Home Phone *

Mailing Address *

City *

Province *

Postal Code *

Country *

Parent/Guardian 1

First Name *

Last Name *

Relationship to Camper *

Cell Phone *

Work Phone

Extension

Parent/Guardian 2

First Name

Last Name

Relationship to Camper

Home Phone

Cell Phone

Work Phone

Extension

Emergency Contact

Different from Parents/Guardians

First Name *

Last Name *

Relationship to Camper *

Home Phone *

Cell Phone *

Work Phone

Extension

Last Few Questions

Does the camper have any physical, emotional, behavioural, learning or social challenges we should be aware of? *

Yes

i.e. ADD/ADHD, ODD, diabetes, FAS/FASD, vision impairments, bed wetting, headaches, cramps, depression, gets frustrated easily, struggles in relationships with others, etc.

Please Explain *

Does your child receive extra help or any type of educational assistance while at school? *

Yes

Please outline what kind of assistance they receive:

Does your child respond well in new or different environments? *

Yes

What helps your child experience success when they try new things?

Has your child experienced bullying before? *

Yes

Are there steps that we can take to help your child feel more secure at camp?

Is there anything else we should know about?

The Wilds - Co-Ed Registration 2021

Registration for The Wilds - Co-Ed - August 8-13, 2021