Childhood Unplugged

July 20 - 24

Ages 6-12 years

9am to 3pm

$65/day or $300 for 5 days

Parent/Guardian First Name

Parent/Guardian Last Name

Phone Number

Full Legal Name of Camp Participant

Camp Participant's Birthdate

Please indicate the days you will be in attendance (Monday and Tuesday are now full):

Wednesday

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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