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2008 Registration Application - Late
Personal Information
*E-Mail:
Valid e-mail is required
*Swimmers First Name:
*Last Name:
*Parent / Guardian First Name
*Last Name
*Address Line 1:
Address Line 2:
*City:
*Province
Choose a Province
British Columbia
Alberta
Saskatchewan
Manitoba
Ontario
Quebec
New Brunswick
Nova Scotia
Newfoundland
Prince Edward Island
Yukon
NWT
Nunavut
Other
If Other Please Specify
*Postal Code:
*Gender:
Select Gender
Male
Female
*Date of Birth:
Month
January
February
March
April
May
June
July
August
September
October
November
December
Day
01
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Year
1984
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2000
2001
*Home Phone:
Work / Cell:
*T-Shirt Size
Select Size
Youth Medium
Youth Large
Small
Medium
Large
X-Large
*100 Freestyle Time
*Select Course
SC
LC
*200 IM Time
*Select Course
SC
LC
*Do you currently suffer from any health issues that may prevent you from participating in the camp?
Yes (please specify below)
No
If Yes, please describe
Camp Information
***Please note that we are now in the Late Registration Period***
This summer we will be offering three week long sessions. Session 1 runs from July 7-11; Session 2 from August 18-22; and Session 3 from August 25-29.
Each week long full day camp costs $375.00 plus GST. Half day camps will be offered for $200.00 plus GST each week.
Athletes may register for any 2 sessions for a cost of $720.00 plus GST or all three sessions for $1050.00 plus GST.
All rates above are Early Bird Rates and are valid until May 31, 2008. After this date the costs increase to $425 for 1 session, $800 for any 2 sessions and $1125.00 for all three sessions plus GST. After the early bird deadline our Half Day camps go up to $225 per week.
Billing Information
*Select Camp:
Choose Item
Session 2: August 18-22, 2008 $425.00
Session 3: August 25-29, 2008 $425.00
Session 2 and Session 3 $800.00
Half Day - Session 2: August 18-22, 2008 $225.00
Half Day - Session 3: August 25-29, 2008 $225.00
Sub-Total:
*GST:
Choose GST
Canada GST %5.00
Grand Total:
By clicking below I understand the Tom Johnson Swim Camps, Super Fish Swimming Inc, the University of British Columbia, its coaches, athletes, staff and related volunteers are not responsible for any injuries sustained by, or accidents happening to participants during camp activities.
*Yes, I have read and understand the above.
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