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Family Camp and Young at Heart Online Registration
Family Camp and Young at Heart Online Registration
For detailed information please consult the
Registration information
before filling out this form.
(* Required)
First name *
Last Name *
Mailing Address *
Mailing Address 2
City *
Province/State
Postal Code *
Country
Telephone *
E-mail *
Accommodation Preferred
1st Choice
2nd Choice
Total # in Party
Number of Adults
Children (names - birthdates)
-
-
-
-
-
-
-
Session
Please Select
Victoria Weekend: May 15-18
Spring Young At Heart: June 27-July 3
Family Week A: August 7-14
Family/Golf Week B: August 14-21
Family Week C: August 21-28
Fall Young At Heart: September 26-October 1
Thanksgiving Weekend: October 8-11
*
Would you care to contribute to our sponsorship fund to assist another child or family attend summer camp? If yes, please enter amount!
Yes/No:
No
Yes
Assist Other Amount:
Credit Card Info
Name on Card:
*
Card Type:
Please Select
Visa
MasterCard
*
Card Number:
*
Expiration Date:
Select Month
01
02
03
04
05
06
07
08
09
10
11
12
Select Year
2008
2009
2010
2011
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2013
2014
2015
2016
*
Security CVV (back of card):
*