SmartieCamp Summer Tour 2018 6 Week Session – July 3rd – Aug 13th (off Aug 6th) Each at a different host’s backyard. Rainy days will run inside Smartiepants or a basement. SmartieCamp Summer Tour Name of child* Full Name Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Date of Birth* How old will he/she be in July?*Home Phone Number*Email* Guardian 1* Full Name Cell Phone*Guardian 2 Full Name Cell PhoneName of Caregiver* Full Name Cell Phone*Who will most often attend with child?*SmartieCamp Summer Tour Dates & Rates*Hayley Resnick's Group - Monday's 10:45-11:45amRachel Philosophe's Group - Monday's 3:30-4:30pmJess Fenton's Group - Tuesday's 9:45-10:45amMarni Pernica's Group - Wednesday's 9:30-10:30amRina Gerson's Group - Thursday's 10:00-11:00amAngela Greenberg's Group - Thursday's 4:00-5:00pmYou have already spoken with the host or Smartiepants if you are signing up for one of these sessions. $25 per day, all paid up front. How did you hear about Smartiepants?*FacebookInstagramWalk byFriend/FamilyWould you like to receive emails about all programs at Smartiepants?*YesNoMedical InformationHealth Card Number (only numbers - no spaces)*Emergency ContactPhone Number*Relationship to child*Doctor's Name* Full Name Phone Number*Does your child have any allergies/health concerns/medications?*YesNoPlease provide detailsPhoto and Video Release ConsentTO:SMARTIEPANTS INC. I am the parent and legal guardian to the child/children listed below and hereby grant permission to SMARTIEPANTS INC., to use photographic and/or videographic media containing his/her likeness or works in future marketing materials and/or social media.I hereby transfer all copyright and other interests in the photograph and/or video taken to SMARTIEPANTS INC. I also hereby grant royalty-free permission, including non-exclusive world rights in all languages, to reproduce and/or include in all formats (including but not limited to print, web consent, social media and online communications the image or likeness or works of my child/children for promotional purposes of SMARTIEPANTS INC. I have read the foregoing release and authorization and confirm and warrant that I fully understand and agree with the contents.Name of Parent/Legal Guardian Full Name Child's Name Full Name Yes, I agree to the photo consent terms and conditions Terms & ConditionsDownload the T&CSignature*I have agree and accept conditions* Yes, I have read terms and conditions CONTACT 1136 Eglinton Avenue West info@smartie-pants.ca 416.546.7733