Camper Name …………………………….    Male     Female        Date of Birth ……………………. 
Grade completed as of June …….              Swimming ability-   Beginner     Fair    Competent
Camped at SLS before   Yes   No               Is there a sibling at this Camp? Name ……………………..
Special Needs/Allergies - ……………………………………………………………………………………….
……………………………………………………………………………………………………………………..
Note: children with very special needs must be accompanied by an aide.
Parent/Guardian Information
Name ………………………………………..            	 Main Phone ……………………….
Address ………………………………………            	Alt. Phone …………………………
City ………………………………… Prov. ……..	           Email …………………………………
Postal Code …..... ……..          Does the Camper reside here?  Yes   No
				  If not, the Camper’s address is ………………………………………
          I am interested in - 	Volunteering at Camp  
-	Joining The Surprise Lake Society
-	Receiving email updates from Camp
-	Donating to the Society
CAMPS: There are four 6 day camps in July, each year, TEVA-1, TEVA-2, TEVA-3, and TEVA-4.
 The camps are for all ages and have mixed accommodations.
The cost for each camp is 	   	   $425.00, or  $385.00 Early  Bird**
Camp T-shirts   S   M   L   XL   @ $20.00	           $ ………...
Camp Ball Cap		      @ $15.00	           $ …………
Camp Choice TEVA- ……      Cost 	           $ …………..
					Deposit	$ …………...  Receipt # ……………
 								Owing		$ ……………	 Receipt # ……………
A Minimum $50.00 Deposit, non refundable, is required.. 
			**The EARLY BIRD DISCOUNT is offered to registrations paid in full prior to May 1

……………………………………….                                     ………………….
Parent/Guardian signature					Date
           Registrations to:						Information:
	Surprise Lake Society					Ian Park, Registrar, 780 963 2810
	Box 2391						idpark@telusplanet.net				Stony Plain, AB, T7Z 1X8