Registration Form for Summer 2018

Camper Information

First Name
Last Name
Age @ Start of Session
Date of Birth (dd / mm / yyyy)
/ /
Number of years at Ak-O-Mak
Home Address: Street
City
Province / State
Country
Postal / Zip Code

PARENT / GUARDIAN 1 NAME:

Home Phone
Cell Phone
E-mail

PARENT / GUARDIAN 2 NAME:

Home Phone
Day/Cell Phone
E-mail

SESSION INFORMATION

(All fees in Canadian Dollars, Includes Base Tuition, plus13% TAX plus Refundable Expense Account)
  Session Term Begins - Ends Complete Tuition
Session 1 7 weeks June 27th, 2018 – August 15th, 2018 $7,274.35
Session 2 4 weeks June 27th, 2018 – July 24th, 2018 $4,655.30
Session 3 2 weeks June 27th, 2018 – July 11th, 2018 $2,303.50
Session 4 3 weeks July 25th, 2018 – August 15th, 2018 $3,513.60
Session 5 2 weeks July 25th, 2018 – August 8th, 2018 $2,303.50
Session 6 2 weeks August 18th, 2018 – September 1st, 2018 $2,171.00
Deposit due upon registration (non-refundable).
Balance due two weeks prior to start of Session
$500.00
Travel to Camp From Toronto Airport. $120.00
Travel To Toronto Airport From Camp. $120.00

Payment Information

Payment Type:
Authorized Amount
Fill out information below if Payment Type is Mastercard or Visa.
Card Number
Expiration Date (mm/yy)
Name on Card

I Confirm that the payment details above are correct.

The $500.00 reservation deposit required for each session can be paid by Cheque, Visa, MasterCard or Wire Transfer. I authorize Camp Ak-O-Mak to use the above credit card for the tuition balance and for the reconciliation of my camper's expense account.

TERMS AND CONDITIONS

  • Early Bird discount applies if Paid In Full by January 31st. 2018
  • You will receive email acknowledgement within 48 hours of receipt of Registration form.
  • A valid credit card is required to reconcile charges in excess of refundable expense account which may include elective events / activities, associated travel / food, medical expenses, camp store; Airport travel, Rentals and extra items if used.
  • Final processing of the Refundable Expense Account will be completed after camp and a statement of accounting emailed to the parent. Please ensure email address is current.
  • Refund Policy: Refund (less $500.00 non-refundable deposit) for cancellation by May 15th. Full refund only for a medial reason with a doctor's note.
  • I agree Camp Ak-O-Mak is released from liability in connection with medical treatment and unavoidable accidents. Camp Ak-O-Mak has my permission to use necessary medical measures in the event of an emergency. My child has permission to leave the campgrounds with authorized camp staff for scheduled trips and outings.

I Agree

Parent / Guardian First Name
Parent / Guardian Last Name
Today's Date

HOW DID YOU HEAR ABOUT Camp Ak-O-Mak?

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  please let us know the location
which publication/website?

Business Office: 14-441 Stonehenge Drive, Ancaster, Ontario, Canada L9K 0B1,
Tel.: 416.427.3171, Fax: 905.304.2982
Email: Dianne@campakomak.com Website: www.campakomak.com

Summer Address: 240 Akomak Road, Ahmic Harbour, Ontario, Canada P0A 1A0,
Tel.: 705.387.3810, Fax: 705.387.0077