JA Camp Startup Registration
Hidden Prefill
Charter
Submitted via online registration form
Opportunity Stage
Payment Information
Paid
Payment Method
Camp Information
Select one of the London camp registration options below:
Please select...
July 6 - 10, 2026
July 13 - 17, 2026
July 20 - 24, 2026
July 27 - 31, 2026
August 10 - 14, 2026
August 17 - 21, 2026
How many children are you registering for this week of camp?
One ($275, no tax)
Two ($550, no tax)
Three ($825, no tax)
Do you
require
before or after camp care?
Please select...
Yes
No
What pre (8-8:30am) and/or post (5-5:30pm) camp care do you
require
?
Regular camp drop-off is 8:30 - 9:00am and pick-up is 4:30 - 5:00pm. Pre-camp care is required for drop-offs between 8 - 8:30am; Post care is required for pick-ups between 5 - 5:30pm.
Please select...
Pre-care only for 1 child [$50]
Pre-care only for 2 children [$100]
Pre-care only for 3 children [$150]
Post-care only for 1 child [$50]
Post-care only for 2 children [$100]
Post care only for 3 children [$150]
Pre and Post Care for 1 child [$100]
Pre and Post Care for 2 children [$200]
Pre and Post Care for 3 children [$300]
Total Amount
Parent/Guardian Contact Info
Parent/Guardian First Name
Parent/Guardian Last Name
Parent/Guardian Email Address
Parent/Guardian Phone Number
Parent/Guardian Mailing Address
Address Line
City
Province
Postal Code
Country
Please provide the full name(s) of any individual(s) approved for picking up your child/children from camp in addition to the parent contact already provided above.
Emergency Contact Info
An emergency contact should be an alternative contact JA can reach out to should the primary parent/ guardian contact not be available. Please provide a different contact than the parent contact provided above.
Emergency Contact First Name
Emergency Contact
Last Name
Emergency Contact
Phone Number
Emergency Contact Relationship to camper(s)
Child 1 Details
Child 1 First Name
Child 1 Last Name
Child 1 Date of Birth
Child 1 Gender
Please select...
Male
Female
Non-binary, gender-variant and/or Two Spirit
Other
Prefer not to say
Child 1 T-Shirt Size
Please select...
Youth Small (S)
Youth Medium (M)
Youth Large (L)
Youth Extra-Large (XL)
Permission to use Child 1's photograph?
Please select...
Yes
No
If Child 1 has allergies, please provide details
If Child 1 requires any medications, please provide details
Additional notes re: Child 1
Child 2 Details
Child 2 First Name
Child 2 Last Name
Child 2 Date of Birth
Child 2 Gender
Please select...
Male
Female
Non-binary, gender-variant and/or Two Spirit
Other
Prefer not to say
Child 2 T-Shirt Size
Please select...
Youth Small (S)
Youth Medium (M)
Youth Large (L)
Youth Extra-Large (XL)
Permission to use Child 2's photograph?
Please select...
Yes
No
If Child 2 has allergies, please provide details
If Child 2 requires any medications, please provide details
Additional notes re: Child 2
Child 3 Details
Child 3 First Name
Child 3 Last Name
Child 3 Date of Birth
Child 3 Gender
Please select...
Male
Female
Non-binary, gender-variant and/or Two Spirit
Other
Prefer not to say
Child 3 T-Shirt Size
Please select...
Youth Small (S)
Youth Medium (M)
Youth Large (L)
Youth Extra-Large (XL)
Permission to use Child 3's photograph?
Please select...
Yes
No
If Child 3 has allergies, please provide details
If Child 3 requires any medications, please provide details
Additional notes re: Child 3
Billing Information
Title
Please select...
Mr.
Mrs.
Miss.
M.
Ms.
Mme
Mlle
Dr.
Prof.
First Name
Last Name
Phone (digits only)
Email
Address Line
City
Province
Postal Code
Country
Payment Information
Cardholder's Name
Credit Card Number
Card Type
Please select...
VISA
American Express
Mastercard
Card Expiry
Month
Please select...
1
2
3
4
5
6
7
8
9
10
11
12
Card Expiry Year
Please select...
2026
2027
2028
2029
2030
2031
2032
2033
2034
2035
Card Security Code