EmailMe Form - Summer Camp registration form

Student

First Last

Birth date

Age

Name of child's school

Grade

Parent's / Guardian's name

Address

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Parent's e-mail

Home phone

### - ### - ####

Cell phone

### - ### - ####

Alternate contact when you're not available

Phone - alternate contact

### - ### - ####

Has you child studied french before?

Yes

No

How many years?

Where?

Child allergies

Please select your program

Summer camp one week

Summer camp morning classes

Summer camp afternoon classes

How did you learn about us?

Internet

Frends

Relatives

Commercial

Signature of parent / guardian (Initials)

Date

MM / DD / YYYY

Payment
The payment for all courses in our location has to be done before the first day of the course (no HST is applied to tuition fees).

Method of payment
Payments can be made by cash or cheque payable to École Napoléon at our location. *

I agree