Camp Registration – New Members Please enable JavaScript in your browser to complete this form.Summer Break Camp Please complete the fields below only if you are registering for a Summer camp.Selection of WeeksWeek 1 - July 5-9Week 2 - July 12-16Week 3 - July 19-23Week 4 - July 26-30Week 5 - Aug 3-6 (*)Week 6 - Aug 9-13Week 7 - Aug 16-20Week 8 - Aug 23-27Please select all of the weeks that you would like your child or children to attend summer camp. Please note that acceptance is based on available space.Day Camp Selection Full Day - 9:00AM to 4:00PMHalf Day - 9:00AM to 12:00PMHalf Day - 1:00PM to 4:00PMPlease select the appropriate full or half day program above.Special requestsIf you have special requests related to camp scheduling, please enter them here and we will do our best to accommodate them.Child InformationGender *MaleFemaleGiven Name *Surname *Date of Birth - ages 4 yrs+ only *DD12345678910111213141516171819202122232425262728293031/MM123456789101112/YYYY20232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Home Address *Address Line 1Address Line 2CityState / Province / RegionPostal CodeAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBolivia (Plurinational State of)Bonaire, Saint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCongo (Democratic Republic of the)Cook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Kingdom of)EthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIran (Islamic Republic of)IraqIreland (Republic of)Isle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea (Democratic People's Republic of)Korea (Republic of)KosovoKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesia (Federated States of)Moldova (Republic of)MonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth Macedonia (Republic of)Northern Mariana IslandsNorwayOmanPakistanPalauPalestine (State of)PanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint Maarten (Dutch part)SlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyrian Arab RepublicTaiwan, Republic of ChinaTajikistanTanzania (United Republic of)ThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUgandaUkraineUnited Arab EmiratesUnited Kingdom of Great Britain and Northern IrelandUnited States Minor Outlying IslandsUnited States of AmericaUruguayUzbekistanVanuatuVatican City StateVenezuela (Bolivarian Republic of)VietnamVirgin Islands (British)Virgin Islands (U.S.)Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland IslandsCountryDoes your child have allergies, medical concerns, special needs or dietary restrictions that we should be aware of? *YesNoIf you answered yes to the previous question, please provide detailsParent / Guardian Information #1Given Name *Surname *Primary Phone *Secondary PhoneEmail *Parent / Guardian Information #2 (optional)Given NameSurnamePrimary PhoneSecondary PhoneEmailEmergency ContactGiven Name *Surname *Relationship to Child *Phone #1 *Phone #2Authorized Pickup Person (optional)If you would like to authorize someone else such as a grandparent or relative to pick up the camper at the end of the day, please enter their name and contact information below. Please note that the person picking up the child will be required to provide identification.Given NameSurnameRelationship to ChildPhone NumberReferrals (optional)Tumbletot are offering a referral bonus to parents that recommend Tumbletot summer camp programs to friends and family. Please enter the name of a person that you wish to refer. For each person referred that confirms a registration, the referred person will receive a $25.00 discount for the summer camp program. The referrer will also receive a $25.00 discount, rebate or credit if any of the people referred register. If three people are referred, the referrer will receive a $50.00 discount, rebate or credit. Please note that referrals are only paid for new members who have not attended a Tumbletot program within the past 24 months.Referral (enter person's name)Enter the name of the person here that you would like to refer to the Tumble Tot Co.Phone # (of person referred)Please enter a phone number if available for the person that you wish to refer.Were you referred by a friend? If so, please tell us the name of the person who referred you so that we can credit them with a referral bonusHow did you hear about us?Please let us know how you learned about Tumble Tot Co. programsExisting customerFriend or family / word of mouthInternet SearchFacebook AdGoogle AdPrint advertismentYellow pagesNot sure / otherPlease let us know how you learned about our programs.Informed Consent Agreement I, the undersigned, hereby agree to indemnify and save harmless The Tumble Tot Co. of Newmarket, their/its officers, instructors, coaches, employees, members and clubs against all claims, demands, damages, actions, suits or proceedings arising out of participation of myself/my child, named above, in any gymnastic activity. I, the undersigned, hereby acknowledge that certain risk of injury are inherent to participation in hand on science, arts and physical fitness & gymnastics activities. These types of injuries may be minor or serious and may result from one’s own actions, or the actions of others, or combination of both. I, hereby warrant that my child is physically fit to participate and understand that the choice to participate brings with it the assumption of those risk and results which are part of these activities. I agree to allow my child to receive basic first aid/medical care from instructors/coaches certified in first aid if necessary. The Tumble Tot Company reserves the right to use photographs of members for promotional purposes. If you do not wish your child’s photograph to be taken please notify The Tumble Tot Company in writing. Refund will not be given. A credit will be applied to a future program for medical reasons only if the request is made in writing and accompanied by a doctor’s note. There is a $30.00 admin fee for this service. A charge of $50.00 will be levied on all NSF cheques. I declare having read and understand the above informed consent agreement in its entirety and hereby consent to participate acknowledging all the foregoing. I also certify that the information provided in this form is, to my knowledge true and complete. Consent *I agree to the above terms. A signature will be required on the first day of camp.MessageSubmit