Printed from ChabadVI.org

Register Online!

Register Online!

Online Pre-Registration!

Please fill out the information below. A full registration package will be mailed to you.

Please use a separate form for each child.

Camper Information
Name
  First
Middle Last  
Address
  Street
City Province
Postal Code
Date of Birth
   
Contact Info
  Phone
Email
 
           
Child's Grade
       
Please indicate which session/s your child will attend camp:
   
   

Week 1 (July 4-7) Full Session (July 4-21)

Week 2 (July 10-14)

Week 3 (July 17-21)

Click here for rates

PAYMENT
 

I will be paying by:
Cheque - mail a cheque to:
Chabad of Vancouver Island
2955 Glasgow Street
Victoria, BC V8T 4H1

Credit card

Name: Last Name:

Address:

Email:

Card Type*
Card Number
Expiration Date
CVV Security Code

 

 
 

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