Parenting Camp Registration Form

*
- I have read and agree the Event Registration Policy.
Adult*
Price: $ 800.00 CAD Quantity:
Parent and children over 18 years old
Dependant
Price: $ 600.00 CAD Quantity:
Children under 18 years old
Extra Cost for Accommodation
Price: $ 100.00 CAD Quantity:
Single Occupancy
Total
$ 0.00 CAD
Participant Information
Name of Adult 1*
First Last
Name of Adult 2
First Last
Relationship to Adult 1
Name of Adult 3
First Last
Relationship to Adult 1
Name of Dependent 2 (Under 18)
First Last
Relationship to Adult 1
Name of Dependent 3 (Under 18)
First Last
Relationship to Adult 1
Contact Information
Email*
Enter Email Confirm Email
Cell Phone*
Home Phone*
Address*
Street Address City Province Postal Code
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Visionary Series 2015 -- Early Bird (Non-members)
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Visionary Series 2015 -- (Non-members)
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- City Warmer: Shoebox Gift DIY -- (Non - Members)
Emergency Contact
Emergency Contact*
First Name, Last Name
Relationship*
Emergency Contact Cell Phone*
Email Subscription*
- I consent to receive electronic communications from Across U-hub. I understand that I can unsubscribe at any time.

Tel:	+1 (905) 944-1944
Fax:	+1 (905) 944-1950
E-mail:	[email protected]
Address:	232 Hood Road, Markham, Ontario, Canada, L3R 3K8 (map)
Hours:	Monday-Friday: 10:00 AM-6:00 PM

Participant Information