Go Kart Sports Camp Registration Form

Please fill out the form below.
Fields marked with *are required.

Spot is reserved upon receipt of payment.
Cost: $325 + tax (367.25) for each week
Cheques payable to Centennial Park Mini Indy
Send cheque to 2458 New Wood Drive, Oakville Ontario L6H 5Y3

Child's name: *

Child's email:

Date of birth: *

Weeks attending:

July 19th-23rd
Aug 9th-13th

*

T-shirt size:

Mailing address: *

Postal code: *

Phone number: *

Guardian #1:

Phone number:

Cell number:

Work number:

Email:

Guardian #2:

Phone number:

Cell number:

Work number:

Email:

Medical Information

Name of family doctor: *

Phone number: *

OHIP #: *

Emergency contact other than guardian: *

Emergency contact phone number: *

Please list and describe and medical or health issues:

Please list any food allergies:

Best way to contact you?

How did you hear about us?