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Please register for the program by completing the form below.

Testing Early Years Summer Camp Toronto

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Fields marked with * are mandatory.
Early Years Services – Registration Form (Toronto):
Parent's Information
Personal Information
*First Name
*Last Name
*Age
*Gender
* Date of Birth (YYYY-MM-DD):
Please fill in at least one of the two phone number input boxes
*Phone:
*Mobile:
*Email
*Address
*Postal Code
*City
*Province
*Language:
Immigration Status and Information
Immigration Status
Country of Origin:
*Home Language:
Camp Weeks
  16-20 March
  23-27 March
  30 March - 3 April
  6-10 April
Extended Hours
Yes ($30/week per child)
No
Child's Information
*First Name
*Last Name
*Gender
Date of Birth:
Status in Canada
Status Other
* Home Language:
 
*Health Card #
*Family Doctor's Name
*Family Doctor’s phone #
*Parent's/Guardian’s Name
*Parent/Guardian’s phone #
For any reason, if parents/ guardian cannot be reached during an emergency, please provide two emergency contact number:
Emergency Contact Name #1
*Name
*Relationship
*Telephone
Emergency Contact Name #2
*Name
*Relationship
*Telephone
*Does your child suffer from any health conditions? Please specify.
*Is your child currently on any medication, please specify:
*Food Allergies
*Medication Allergies
*Other Allergies
Additional Comments
Parent/Guardians Authorization
Agreement , Consent & Medication Authorization * Participants should take care of their own safety. CICS is not liable for any personal injury and/or loss/damage of personal property.
I hereby give permission for my photos or videos to be taken in CICS activities, and also give consent to CICS to use them for promotional purposes through its media outlets.
I hereby give permission to CICS to deliver agency information to my email address.
* I hereby give permission for my child to participate in the above activity and to receive emergency treatment, if necessary. I hereby release CICS from all claims arising from any accident, loss or injury which are caused by or arisen from such participation and/or treatment.
* Security Number: Type the numbers you see in the block
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