Music Magic

Music Day Camp and the Home of David Irving

Music Magic Camp Registration

Registration will be confirmed by telephone using the contact information provided.

Payment must be made by cash or certified cheque made payable to David A. Irving.

Registration limited to 15 children per week.

Cost: $120.00/week, there is a $20 fee for the after 3 daycare

This is an electronic registration form, information collected here is not
stored on our server,  you can fill it in at home and bring it to the first day of camp.
Fields marked (*) are required

Child’s Name*:

Child’s Address*:

City*:

Province*:

Postal Code:

Phone Number*:

Provincial Health Insurance Number*:

Family Doctor Name*:

Family Doctor Phone Number*:

Allergies/Medication*?

Weeks Requested*:

Parent/Guardian Name*:

Address (if different from above):

City:

Province:

Postal Code:

Home Phone Number*:

Work Phone Number*:

Cell Phone Number:

People to contact in case you cannot be reached and whom you authorize
to pick-up your child. *

Name:

Phone Number:

Name:

Phone Number:

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