March Break Camp Registration Form
Oxford Learning Centre, High Park
March Break Camp Registration Form Student information: Name : __________________________________
Date of Birth (d/m/y): ___________________
Address:
Grade:__________________________________
___________________________________________________ ___________________________________________________ ___________________________________________________
School:__________________________________ Postal Code: __________________________________
Areas of Concern (if any): _____________________________________________________________________________________ _____________________________________________________________________________________ Health Information: Allergies/ Medical concerns: _____________________________________________________________________________________ _____________________________________________________________________________________ Health Card Number:________________________________________________________________ Parent/ Guardian Information: Full Name : ______________________________ Relationship to student: __________________
Home Phone: __________________________
Address: _______________________________________
Cell phone:_____________________________ Work phone:____________________________
___________________________________________________ ___________________________________________________
Email: __________________________________
Emergency Contact: Full Name:_______________________________
Relationship to student:__________________
Home Phone:____________________________
Cell Phone: _____________________________
Who is allowed to pick up your child? ______________________________________________________ Oxford Learning High Park 406 B Pacific Ave., Toronto, ON M6P 1R4 416-762-4447 [email protected]
March Camp Enrollment Please check one of the following programs: Full week (March 12th - March 16th, 2018)
($385)
Specific Days: _______________________________________________
Full Day ($80)
**Before care (9:00 am) and After Care (until 5:00 pm) is available at an extra charge.
Cancellations: Cancellations require written notice and we will charge a nonrefundable deposit of $50.00 for all cancellations. We require one month written cancellation notice; all sessions cancelled with less than a month’s notice are nonrefundable. Total Cost for Camp: _______
Before/Aftercare: _________
Total Cost: ____________
Payment: Payment can be made by credit card, cash or by cheque, payable to Oxford Learning High Park. Cheque Cash Credit card:
Visa
Mastercard
Card Number: __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ Cardholder’s name (exactly as printed on card): _____________________________________ CCV: ________ Exp: m___________ y______________ Signature: __________________________________________________________________________ Date: ______________________________ I have read and understood the terms of enrollment. __________________________ Name of Parent/Guardian
_____________________________ Signature of Parent/ Guardian
___________________ Date
Oxford Learning High Park 406 B Pacific Ave., Toronto, ON M6P 1R4 416-762-4447 [email protected]
March Break Camp Registration Form Student information: Name : __________________________________
Date of Birth (d/m/y): ___________________
Address:
Grade:__________________________________
___________________________________________________ ___________________________________________________ ___________________________________________________
School:__________________________________ Postal Code: __________________________________
Areas of Concern (if any): _____________________________________________________________________________________ _____________________________________________________________________________________ Health Information: Allergies/ Medical concerns: _____________________________________________________________________________________ _____________________________________________________________________________________ Health Card Number:________________________________________________________________ Parent/ Guardian Information: Full Name : ______________________________ Relationship to student: __________________
Home Phone: __________________________
Address: _______________________________________
Cell phone:_____________________________ Work phone:____________________________
___________________________________________________ ___________________________________________________
Email: __________________________________
Emergency Contact: Full Name:_______________________________
Relationship to student:__________________
Home Phone:____________________________
Cell Phone: _____________________________
Who is allowed to pick up your child? ______________________________________________________ Oxford Learning High Park 406 B Pacific Ave., Toronto, ON M6P 1R4 416-762-4447 [email protected]
March Camp Enrollment Please check one of the following programs: Full week (March 12th - March 16th, 2018)
($385)
Specific Days: _______________________________________________
Full Day ($80)
**Before care (9:00 am) and After Care (until 5:00 pm) is available at an extra charge.
Cancellations: Cancellations require written notice and we will charge a nonrefundable deposit of $50.00 for all cancellations. We require one month written cancellation notice; all sessions cancelled with less than a month’s notice are nonrefundable. Total Cost for Camp: _______
Before/Aftercare: _________
Total Cost: ____________
Payment: Payment can be made by credit card, cash or by cheque, payable to Oxford Learning High Park. Cheque Cash Credit card:
Visa
Mastercard
Card Number: __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ Cardholder’s name (exactly as printed on card): _____________________________________ CCV: ________ Exp: m___________ y______________ Signature: __________________________________________________________________________ Date: ______________________________ I have read and understood the terms of enrollment. __________________________ Name of Parent/Guardian
_____________________________ Signature of Parent/ Guardian
___________________ Date
Oxford Learning High Park 406 B Pacific Ave., Toronto, ON M6P 1R4 416-762-4447 [email protected]
