2020 Summer Camp Registration

 

WELCOME TO SUMMER ARTS CAMP 2020!

Registration is a two step process:

STEP 1: Registration Form ~ Please ensure that you press “SUBMIT REGISTRATION” at the end of the form before proceeding to payment.

STEP 2: Payment ~ Add to Cart buttons selected will take you directly to PayPal.  If you do not have a PayPal account, please choose the “Check Out – Pay without a PayPal account” button on the shopping cart page.

CONFIRMATION: Once the registration form and payment have been submitted, you will receive a confirmation email from Glenhyrst.  This is not an automatic email, and will be sent as soon as possible following your registration.

If you have any questions or require assistance, please call the Gallery at 519-756-5932.

 

Please read our CAMP SAFETY POLICY before proceeding to registration. You will need to check off that have done so before submitting the registration form, and this page contains important information.

 

STEP 1: REGISTRATION FORM

CHILD AND FAMILY INFORMATION

CHILD'S FIRST NAME:
*REQUIRED FIELD

CHILD'S LAST NAME:
*REQUIRED FIELD

BIRTHDATE YYYY-MM-DD:
*REQUIRED FIELD

CHILD'S ADDRESS:

*REQUIRED FIELD
CITY:

*REQUIRED FIELD
POSTAL CODE:

HOME PHONE NUMBER:
*REQUIRED FIELD

RESIDES WITH:
*REQUIRED FIELD


PRIMARY CONTACT:
*REQUIRED FIELD

RELATIONSHIP TO CHILD:
*REQUIRED FIELD

DAY PHONE NUMBER:
*REQUIRED FIELD

CELL PHONE NUMBER:
*REQUIRED FIELD

EMAIL (USED TO SEND OUT CAMP INFORMATION):
*REQUIRED FIELD

SECONDARY CONTACT:
*REQUIRED FIELD

RELATIONSHIP TO CHILD:

DAY PHONE NUMBER:
*REQUIRED FIELD

CELL PHONE NUMBER:
*REQUIRED FIELD


EMERGENCY CONTACTS (IF PRIMARY OR OR SECONDARY CONTACTS CANNOT BE REACHED). AN ADULT 16 YEARS OR OLDER WHO CAN ASSUME RESPONSIBILITY FOR THE CHILD).
NAME:
*REQUIRED FIELD

RELATIONSHIP TO CHILD:
*REQUIRED FIELD

DAY PHONE NUMBER:
*REQUIRED FIELD

CELL PHONE NUMBER:
*REQUIRED FIELD


AUTHORIZED PICKUP:
NAME OF PERSON(S) WHO CAN PICK UP CHILD (IF APPLICABLE) OTHER THAN PRIMARY OR SECONDARY CONTACTS OR EMERGENCY CONTACTS:
*REQUIRED FIELD

DO YOU GIVE US PERMISSION TO TAKE PHOTOS OF YOUR CHILD FOR PROMOTIONAL PURPOSES? NAMES WILL NOT BE USED.YESNO


INDIVIDUAL CAMPER INFORMATION

Indicate if came experiences or has experienced any of the following:

ALLERGIES:YESNO
IF YES, INDICATE TYPE:

MEDICAL: (ie: Vision/hearing/seizures/Diabetes/Mobility:

ASTHMA:YESNO
INHALER:YESNO

CURRENTLY TAKING MEDICATION?YESNO
IF YES INDICATE TYPE:

DEVELOPMENTAL/LEARNING: (ie: ADD/ADHD/Autism/Delays):YESNO
IF YES INDICATE DETAILS:

DOES YOUR CHILD REQUIRE ADDITIONAL ASSISTANCE? YESNO
If yes indicate if there is anything we should know concerning school, relationships, learning abilities, etc?

DOES YOUR CHILD REQUIRE AN EA AT SCHOOL? YESNO
IF YES, PLEASE INDICATE IF AN EA HAS BEEN ARRANGED FOR CAMP (Camp policy states that if an EA is required at school then an EA must also accompany your child during camp).

IS YOUR CHILD IMMUNIZED?YESNO

PLEASE CHECK TO INDICATE YOU HAVE READ AND UNDERSTAND THE CAMP POLICIES AND SAFETY GUIDE.

Yes I have read the Camp Safety Policy.

CLICK ON THE BUTTON BELOW TO SUBMIT YOUR FORM. PLEASE NOTE THAT PAYMENT IS A SEPARATE STEP THAT IS PROCESSED THROUGH PAYPAL. REGISTRATION CANNOT BE COMPLETED WITHOUT BOTH THE COMPLETED REGISTRATION FORM AND PAYMENT.

 

Please ensure that you have pressed the “SUBMIT REGISTRATION” button BEFORE selecting your payment buttons.

 

STEP 2: PAYMENT

Not yet a member? Purchase a Youth membership for $20, or Family membership for $40, and receive the member pricing on each camp week!


Membership Types




WEEK 1: June 29th – July 3rd (4 day camp)
ATLANTIS: THE LOST CITY


Registration Fees
Child’s Name:
Parent Phone Number:





WEEK 2: JULY 6th – 10th
MYTHICAL BEASTS


Registration Fees
Child’s Name:
Parent Phone Number:




WEEK 3: July 13th – 17th
IN THE JUNGLE


Registration Fees
Child’s Name:
Parent Phone Number:




WEEK 4: July 20th – 24th
JEDI ACADEMY


Registration Fees
Child’s Name:
Parent Phone Number:



WEEK 5: July 27th – 31st
CLAY ALL DAY!


Registration Fees
Child’s Name:
Parent Phone Number:



WEEK 6: August 4th – 7th (4 day week)
ESCAPE THIS!


Registration Fees
Child’s Name:
Parent Phone Number:



WEEK 7: August 10th – 14th
WORLD RESCUE RANGERS


Registration Fees
Child’s Name:
Parent Phone Number:



WEEK 8: August 17th – 21st
STEAM: WIERD SCIENCE


Registration Fees
Child’s Name:
Parent Phone Number:



WEEK 9: August 24th – 28th
X-FACTOR GLENHYRST


Registration Fees
Child’s Name:
Parent Phone Number:



WEEK 10: August 31st – September 4th
MARVEL MADNESS


Registration Fees
Child’s Name:
Parent Phone Number: