BFL's United Way School Out Summer Camp Contact List

Title *

Today's Date: *

SUBMITTING THIS FORM DOES NOT CONFIRM YOUR SPOT. WE HAVE LIMITED SPACES AVAILABLE AND YOU WILL BE CONTACTED TO CONFIRM IF YOU HAVE BEEN GIVEN A SPOT.

Parent Name: *

Email Address: *

Phone Number: *

Which session are you interested in? Select all dates you are available. *

Session 1: July 6-July 17

Session 2: July 20-July 31

Session 3: August 4- August 14

Note that signing up on this list DOES NOT guarantee your child a spot in the program. If you are contacted and confirmed your child has a spot, they must participate in both weeks of the session.

Please indicate the name and/organization that referred you to this program? *

Note that you must be referred directly from BFL or Edmonds Community School to be eligible for this program.

Have you ever participated in a BFL's School's Out Summer Camp Program? *

Note that we will confirm this information as priority will be given to new families who have not previously participated in a BFL Schools Out program.

Do you identify as a newcomer to Canada? *

Newcomer is defined as a family that has been in Canada less than 5 years.

What school does your child attend? *

How many children are you signing up in your family? *

Maximum 3 children per family. Please use the fields below to enter each child's name and date of birth separately.

Child 1 Name: *

Child 1 Date of Birth: *

All children must be between the ages of 6 and 12 to be eligible.

Child 2 Name:

Child 2 Date of Birth:

All children must be between the ages of 6 and 12 to be eligible.

Child 3 Name:

Child 3 Date of Birth:

All children must be between the ages of 6 and 12 to be eligible.

ADMIN ONLY (DO NOT EDIT): *

DO NOT EDIT. You will only be confirmed once we contact you.

ADMIN ONLY (DO NOT EDIT): Contacted *

ADMIN ONLY

BFL's United Way School Out Summer Camp Contact List - New Item