Full Name:      
Street Address:
City, Prov:       
Postal Code:    
Home Phone:  

E-Mail address:

Birthdate:      Height:      Weight:

Weeks available for volunteering:
Do you have a current First Aid Certificate Yes No
Are you interested in acheiving your Rider Level 1 Certificate Yes No Already have
Are you an OEF Member Yes No

Family Doctor   
Health Card No.
Telephone #      

T-shirt size:  Youth  S    M     L      Adult  S    M    L

Do you have any medical condition, allergies or any other conditions we should be aware of? No   Yes 
If yes, please describe:

 Signature of Parent/ Guardian:

____________________________________________________________________

Full name of Parent/Guardian:
Phone # where Parent/Guardian can be reached during the day during camp week:

Leadership Camp attach a cheque for $200.00 and a postdated one for $303.50  for June 15, 2008, Applications are due by March 1st 2008
 
 Make cheques payable to Teri Lindsay  and mail to:

South Algonquin Summer Camp  
1158 Birch Rd  
Gilford, Ontario
L0L 1R0
705-456-5075     866-237-8386  705-455-9166