Registration Winter Camp

REGISTRATION FORM
WINTER-WONDER-CIRQUE-CAMP 2011

Student Name *

First

Last

Date of Birth *

Gender *

Male Female

Parent / Gardian Name (if under the age of 18) *

Email *

Phone Number *

Address *

City / Province *

Postal Code *

Where did you hear about Atlantic Cirque? *

Allergies / Medications *

Emergency Contact Info *

Please select the week(s) you are registering for *

Winter Camp -December 19th to 23rd 2011

By registering at Atlantic Cirque, I am acknowledging that I am aware of the following. (please check all) *

There will be a $20 insurance fee per student per camp. Cancellation within 14 days of less from the start of the camp will incur a $100 cancellation fee. The price per participant for the full week is $275 (+HST) A $100 deposit is due upon registration. By registering, I am committing to paying the full amount and understand that there will be no refund once the camp has stated.

All prices are quoted in Canadian Dollars (CDN)
Prices on this website are subject to HST (15% as of July 1st 2010)
All classes are subject to enrollment.
Atlantic Cirque reserves the right to cancel any class due to limited enrollment.
All cancellations within 14 days of the beginning of a session will incur a $100 cancellation fee.
There will be no refunds once the session has started

REGISTRATION FORMWINTER-WONDER-CIRQUE-CAMP 2011

REGISTRATION FORM
WINTER-WONDER-CIRQUE-CAMP 2011