Kids Club Registration *Denotes Required Field * Title * First Name * Last Name * Email * Phone () – * Address 1 Address 2 * City State/Prov * Zip/Postal Code * Grade Entering * School Name * Child's Birthdate * Name of Parent(s) * Emergency Contact Name * Emergency Contact Phone Number * List any allergies or medical/behavioural concerns * I give permission for pictures/videos of my child to be taken and used for EBC Day camp promotion.
