Summer Day Camp Information Package - Ontario Science Centre

Summer Day CampMedical / Special Needs FormIf you have not already sent us your child(ren)’s medical / special needs information,please use this form for all children listed on your confirmation. If you have no medical / specialneeds, you do not need to submit this form.Registering Parent _______________________(Parent’s first and last name)Confirmation Number CS_____________Camper 1 _______________________(Child’s first and last name)Please describe any medical conditions, allergies, and/ or dietary needs.__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Please describe any special needs (e.g. physical/ learning disabilities, behavioural concerns, etc.)__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Camper 2 _______________________(Child’s first and last name)Please describe any medical conditions, allergies, and/ or dietary needs.__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Please describe any special needs (e.g. physical/ learning disabilities, behavioural concerns, etc.)__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Camper 3 _______________________ (Child’s first and last name)Please describe any medical conditions, allergies, and/ or dietary needs.__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Please describe any special needs (e.g. physical/ learning disabilities, behavioural concerns, etc.)__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________SEND FORMEmail:Fax: 416-696-3139CampFirstAidProvider@OntarioScienceCentre.caThis information is collected under the authority of the Centennial Centre of Science and Technology Act, for registration purposes.If you have any questions about this collection please contact: Manager, Educational Sales and Support Services,Ontario Science Centre, 770 Don Mills Road, Toronto, ON M3C 1T3 Phone: 416-696-3256Page 6 6/18/2013