Film Camp for Kids

Film Camp for Kids

Youth Registration

Thank you for registering with Film Camp for Kids & Youth. Due to COVID-19, we are only offering virtual programming at this time.

The Registration Form is required for every participant. Per Privacy Legislation, all information is held confidentially.  On-line classes are FREE in Fall 2020.

Once complete, press SUBMIT – a copy is sent to your in-box. If you do not receive it, email us at info@filmcampforkids.com

REGISTRAION FORM

    PLEASE VERIFY THAT ALL BOXES WITH A STAR (*) ARE FILLED IN BEFORE PRESSING SEND.

    PARTICIPANT AND CLASS REGISTRATION INFORMATION - YOU WILL NEED TO DECIDE CLASSES AND DATES BEFORE FILLING THIS OUT
    Last Name*
    First Name*
    Nick Name
    Year of Birth*
    Gender*
    MF
    Age*
    Grade*
    School
    Address
    City and Province or State*
    Postal Code
    Contact/Family Email*
    Class Name, Date and Cost #1*
    Class Name, Date and Cost #2
    Class Name, Date and Cost #3
    Class Name, Date and Cost #4
    Class Name, Date and Cost #5
    Class Name, Date and Cost #6
    Class Name, Date and Cost #7
    Total Owing (Classes are free in Fall 2020)
    MEDICAL INFORMATION
    Health Card Number
    Doctor's Name*
    Doctor's Office Address
    Doctor Phone Number*
    Allergies*
    YesNo
    If yes, please specify any prescriptions and/or instructions required.
    Are there any other medical or behavioural conditions we should be aware of? If yes, please specify:
    Carries EpiPen -required*
    YesNo
    Wears Medic-Alert Bracelet - required*
    YesNo
    For
    EMERGENCY or PARENT GUARDIAN (if under 18) CONTACT INFORMATION

    PRIMARY CONTACT

    First Name*
    Last Name*
    Gender*
    MF
    Home Phone*
    Work Phone
    Cell Phone
    Address
    City and Province or State*
    Postal Code
    Email*
    Relationship to Registrant*

    SECONDARY CONTACT

    First Name
    Last Name
    Gender
    MF
    Home Phone
    Work Phone
    Cell Phone
    Address
    City and Province or State
    Postal Code
    Email
    Relationship to Registrant

    PLEASE READ AND CHECK ALL BOXES

    I have read and understand the Code of Conduct
    I have read and understand the Photo/Video Consent, Assignment and Release Form
    I have read and understand the Assumption of Risk and Indemnifying Release Form
    I have read and understand the procedure in case of Medical Emergencies
    I have read and understand the Parent/Guardian Permission Form


    Film Camp for Kids & Youth is a non-profit program operated by the Windsor centre for Film, Digital Media and the Creative Arts.