APPLICATION SUMMER SUNSHINE DAY CAMP
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Child's Name:  |
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| Parent/Guardian's Name(s): |
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| Child's Age: |
Gender: F M | Sask. Health #: |
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| Address: |
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| Phone: (H) |
(W): |
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| Child's School: |
Grade: |
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| Phone: |
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Nature of Child's LD (if any):
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Does the child have any other medical/social difficulties that the counselors and staff should be aware of (mediations, allergies,etc.)
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Please indicate the session(s) the child will be attending: |
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July 7 - 18 |
July 21 - Aug 1 |
Aug 4 - 15 |
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Please return completed application and a cheque dated the first day of your selected session, to: LDAS |
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