Terra Nova Day Camp - Montreal

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Registered Charity #106868847RR0001

© 2021 Youth for Christ Canada

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COVID SAFETY MEASURES

Registered Charity #11904 5268 RR0001

© 2024 Montreal Youth Unlimited

Montreal
Terra Nova Day Camp

Registration

How many children will you be registering?*
Please enter a number from 1 to 3.
Please note if you are registering more than 3 children you will need to submit another form – thank you.
Parent/Guardian #1*
First Last
Relationship to child*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Cell Phone*
Email*
Consent*
I agree to the privacy policy.
Date
MM slash DD slash YYYY
Releve 24 Information*
- Yes
- No
Would you like to receive a Releve 24? They will be issued on or before Feb 28th 2025.
Social Insurance Number (SIN)

You must enter a Social Insurance Number to receive a tax reciept.
Parent/Guardian #2*
First Last
Relationship to child*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Cell Phone*
Email*
Child #1*
First Last
Date of Birth (YYYY-MM-DD)*
Gender*
- Male
- Female
Preferred language of child*
- French
- English
Medicaire Number and Expiry
Does your child have any allergies*
- Yes
- No
Please provide information on allergies*
Does your child take any medication*
- Yes
- No
Please provide information on medication*
Is there anything else we should be aware of concerning your child?
Do you consent to your child participating in excursions outside of the youth centre?*
- Yes
- No
Do you consent to photographs of your child being used for promotional purposes?*
- Yes
- No
Child #1, July 1st-5th, Regular Hours Quantity
Price: $ 170.00 CAD
Child #1, July 8th-12th, Regular Hours Quantity
Price: $ 170.00 CAD
Child #1, July 15th-19th, Regular Hours Quantity
Price: $ 170.00 CAD
Child #1, July 22nd-26th, Regular Hours Quantity
Price: $ 170.00 CAD
Child #1, July 29th-August 2nd, Regular Hours Quantity
Price: $ 170.00 CAD
Child #1, August 5th-9th, Regular Hours Quantity
Price: $ 170.00 CAD
Child #1, Optional Day Care – enter number of weeks Quantity
Price: $ 30.00 CAD
Child #2
First Last
Date of Birth (YYYY-MM-DD)
Gender
- Male
- Female
Preferred language of child
- French
- English
Medicaire Number and Expiry
Does your child have any allergies
- Yes
- No
Please provide information on allergies
Does your child take any medication
- Yes
- No
Please provide information on medication
Is there anything else we should be aware of concerning your child?
Do you consent to your child participating in excursions outside of the youth centre?
- Yes
- No
Do you consent to photographs of your child being used for promotional purposes?
- Yes
- No
Child #2, July 1st-5th, Regular Hours Quantity
Price: $ 170.00 CAD
Child #2, July 8th-12th, Regular Hours Quantity
Price: $ 170.00 CAD
Child #2, July 15th-19th, Regular Hours Quantity
Price: $ 170.00 CAD
Child #2,July 22nd-26th, Regular Hours Quantity
Price: $ 170.00 CAD
Child #2, July 29th-August 2nd, Regular Hours Quantity
Price: $ 170.00 CAD
Child #2, August 5th-9th, Regular Hours Quantity
Price: $ 170.00 CAD
Child #2, Optional Day Care – enter number of weeks Quantity
Price: $ 30.00 CAD
Child #3
First Last
Date of Birth (YYYY-MM-DD)
Gender
- Male
- Female
Preferred language of child
- French
- English
Medicaire Number and Expiry
Does your child have any allergies
- Yes
- No
Please provide information on allergies
Does your child take any medication
- Yes
- No
Please provide information on medication
Is there anything else we should be aware of concerning your child?
Do you consent to your child participating in excursions outside of the youth centre?
- Yes
- No
Do you consent to photographs of your child being used for promotional purposes?
- Yes
- No
Child #3, July1st-5th, Regular Hours Quantity
Price: $ 170.00 CAD
Child #3, July 8th-12th, Regular Hours Quantity
Price: $ 170.00 CAD
Child #3, July 15th-19th, Regular Hours Quantity
Price: $ 170.00 CAD
Child #3, July 22nd-26th, Regular Hours Quantity
Price: $ 170.00 CAD
Child #3, July 29th-August 2ndh, Regular Hours Quantity
Price: $ 170.00 CAD
Child #3, August 5th-9th, Regular Hours Quantity
Price: $ 170.00 CAD
Child #3, Optional Day Care – enter number of weeks Quantity
Price: $ 30.00 CAD
Total
$ 0.00 CAD

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Tel (514) 420-0446

Head office located at:
298 Brookhaven Avenue
Dorval, QC H9S 2N4
CANADA

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© 2024 Montreal Youth Unlimited

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COVID SAFETY MEASURES

Registered Charity #11904 5268 RR0001