Childhood Unplugged

August 24 - 28

Ages 6-12 years

9am to 3pm

$65/day

Parent/Guardian First Name

Parent/Guardian Last Name

Email

Phone Number

Full Legal Name of Camp Participant

Camp Participant's Birthdate

If no, please indicate the days you will be in attendance (Tuesday & Wednesday are full).

Monday

Thursday

Friday

Does your child have any medical conditions we should be made aware of, including severe allergies?

If yes, please provide all necessary details below.

Primary Emergency Contact Name

Primary Contact Emergency Contact Number

Secondary Emergency Contact Name

Secondary Emergency Contact Number

I understand that full payment must be sent to hello@campmillstone.ca to secure my child's spot in the camp. The cost is $65 per day for partial attendance, or $300 for 5 full days.

Yes

Childhood Unplugged

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