Before and After School Program DAY CAMP Schools Out Day Camp, Week-long Day Camp, Summer Day Camp. Child's InformationIs your child currently enrolled in a YMCA of Regina Before & After School program?* Yes No Which B&A School Site is your child enrolled at?*École MasseyÉcole St. Pius XGeorge LeeWhich School is your child enrolled at?*École MasseyÉcole St. Pius XGeorge LeePayment is due upon registrationIf your child(ren) is currently enrolled in the B&A Program, the payment for camp will automatically be scheduled just like your B&A payments.You will be contacted for payment once your registration is completeCamp SelectionWhich School's Out Day Camp / Week Long Day Camp are you registering for? October 2, 2023 October 23, 2023 November 10, 2023 January 15, 2024 **February 20 - 23, 2024 March 11, 2024 April 2 - 5, 2024 May 10, 2024 June 14, 2024 Which School's Out Day Camp / Week Long Day Camp are you registering for? October 2, 2023 October 23, 2023 November 10, 2023 January 19, 2024 **February 20 - 23, 2024 March 11, 2024 April 2 - 5, 2024 May 17, 2024 June 14, 2024 Which Summer Day Camp are you registering for? **July 2-5, 2024 July 8-12, 2024 July 15-19, 2024 July 22-26, 2024 July 29-August 2, 2024 **August 6-9, 2024 August 12-16, 2024 August 19-23, 2024 August 26-30, 2024 Child's Name* First Last Child's date of birth* MM slash DD slash YYYY Child's age*Please enter a number from 0 to 12.Does your child have any allergies that we need to be aware of?* Yes No If you answered yes to the above question, please list any allergies your child has:Does your child take medication on a regular basis?* Yes No If you answered yes to the above question, please list all medications:Does your child have a known medical condition?* Yes No If you answered yes to the above question, please list the medical condition:Please list any concerns/limitations in regards to your child's medication and/or treatment:Parent/Guardian InformationParent/Guardian #1 Name* First Last Parent/Guardian #1 Cell Phone*Parent/Guardian #1 Work PhoneParent/Guardian #1 Home PhoneParent/Guardian #1 Email* Parent/Guardian #2 Name* First Last Parent/Guardian #2 Cell Phone*Parent/Guardian #2 Work PhoneParent/Guardian #2 Home PhoneParent/Guardian #2 Email* Emergency ContactEmergency Contact Name* First Last Relationship to Child* Emergency Contact Cell Phone*Emergency Contact Work PhoneEmergency Contact Home PhoneAny other information that we should be aware of? Before and After School Program DAY CAMP Schools Out Day Camp, Week-long Day Camp, Summer Day Camp. Child's InformationIs your child currently enrolled in a YMCA of Regina Before & After School program?* Yes No Which B&A School Site is your child enrolled at?*École MasseyÉcole St. Pius XGeorge LeeWhich School is your child enrolled at?*École MasseyÉcole St. Pius XGeorge LeePayment is due upon registrationIf your child(ren) is currently enrolled in the B&A Program, the payment for camp will automatically be scheduled just like your B&A payments.You will be contacted for payment once your registration is completeCamp SelectionWhich School's Out Day Camp / Week Long Day Camp are you registering for? October 2, 2023 October 23, 2023 November 10, 2023 January 15, 2024 **February 20 – 23, 2024 March 11, 2024 April 2 – 5, 2024 May 10, 2024 June 14, 2024 Which School's Out Day Camp / Week Long Day Camp are you registering for? October 2, 2023 October 23, 2023 November 10, 2023 January 19, 2024 **February 20 – 23, 2024 March 11, 2024 April 2 – 5, 2024 May 17, 2024 June 14, 2024 Which Summer Day Camp are you registering for? **July 2-5, 2024 July 8-12, 2024 July 15-19, 2024 July 22-26, 2024 July 29-August 2, 2024 **August 6-9, 2024 August 12-16, 2024 August 19-23, 2024 August 26-30, 2024 Child's Name* First Last Child's date of birth* MM slash DD slash YYYY Child's age*Please enter a number from 0 to 12.Does your child have any allergies that we need to be aware of?* Yes No If you answered yes to the above question, please list any allergies your child has:Does your child take medication on a regular basis?* Yes No If you answered yes to the above question, please list all medications:Does your child have a known medical condition?* Yes No If you answered yes to the above question, please list the medical condition:Please list any concerns/limitations in regards to your child's medication and/or treatment:Parent/Guardian InformationParent/Guardian #1 Name* First Last Parent/Guardian #1 Cell Phone*Parent/Guardian #1 Work PhoneParent/Guardian #1 Home PhoneParent/Guardian #1 Email* Parent/Guardian #2 Name* First Last Parent/Guardian #2 Cell Phone*Parent/Guardian #2 Work PhoneParent/Guardian #2 Home PhoneParent/Guardian #2 Email* Emergency ContactEmergency Contact Name* First Last Relationship to Child* Emergency Contact Cell Phone*Emergency Contact Work PhoneEmergency Contact Home PhoneAny other information that we should be aware of?