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From The Top Arts Camp Registration Form

Registration is a 2 step process. Step 1 is to complete the form below. Step 2 will be to make a payment. Once you 'Submit' the form below, you will be taken to a link to our secure Payment Page. If you prefer to pay by cheque and/or to mail in your registration, please download and print our Offline Registration and Payment Form. As this form is new, please let us know if you have any problems in completing and submitting it.

Camper Name
First Last
Name of Parent(s)/Guardian(s)

List all Parent(s) / Guardian(s) that are living at the address below.
Address
Street Address

Address Line 2

City

State / Province / Region

Postal / Zip Code

Country
Gender
Male Female
T-Shirt Size (adult unisex sizes - closer to men's sizes)
Small (S) Medium (M) Large (L) Extra-Large (XL)
Home Phone
(To avoid possible difficulty in successfully submitting this form, for any phone field that does not apply please enter 000-000-0000.)
- (###) - ### ####
Work Phone
- (###) - ### ####
Cell Phone
- (###) - ### ####
Emergency Phone (During week of camp)
- (###) - ### ####
Name Of Emergency Contact
Relationship To Contact
Camper Email
Parent/Guardian Email
Healthcare ID Number
Age
Birthdate
/ MM / DD YYYY
Grade Going Into (as of Sept/12)
Booth University College has both single and double rooms: Would your preference be a single room or in a double with a roomate? Single Room Double Room (with Roomate)
Roomate Preference (If Applicable)
Will you be bringing medication to camp?
Do you have allergies, food sensitivities, or other medical information which we need to know?
Are you a NEW or RETURNING camper?
New Returning
How did you hear about camp?
saw Poster was given Flyer received Flyer in the mail word of Mouth Church School Christian Bookstore Community Center/Recreation Center Public Library Store Other
Check one or more of the following.

Security Code:

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