Day Camp Registration - Philip J. Currie Dinosaur Museum

Date of Event:(Required)

Age(Required)

Name of Participant:(Required)

First Last

Address(Required)

Street Address Address Line 2 City Province Postal Code

Parent/Guardian:(Required)

First Last

Relationship to Participant:

First Last

Phone(Required)

Email(Required)

If someone other than the above mentioned parent/guardian will be chaperoning please fill out the following questions.

Name

First Last

Phone

Email

Please list any allergies, medical concerns, medication(s) or dietary restrictions.(Required)

Emergency Contact

Name(Required)

First Last

Phone(Required)

Email(Required)

Relationship to Participant:(Required)

For payment information and to return this completed registration form please contact Brittany Kelsey, Visitor Services Coordinator at 780-832-1995 or bkelsey@dinomuseum.ca