Centre Nautique Pierre Plouffe Tremblant

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Pierre Plouffe
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Enjoy your summer!

819 681-5634 1 888-681-5634 • Français

Day camp registration

- Step 1 of 3

Child informations *

First

Last

Gender *

Female
Male
Other

Age on June 24, 2023 *

Date of birth (MM/DD/YYYY) *

Spoken language of child *

French
English
Bilingual

Dates for the camp

Starting date (first day at the camp) *

Number of days *

Details

Type of days *

Full day (9:30 AM to 4:30 PM)
Half-day (9:30 AM to noon)

Swimming habilities

Veuillez sélectionner l'option qui représente le mieux les habiletés de votre enfant *

Beginner (always needs a life vest to swim)
Intermediate (is comfortable but needs a life vest in deep water)
Advance (can swim without a life vest in deep water)

Medical background

Medical Background

Serious injuries
Chronic or recurrent illnesses
None

Details

Does your child suffer from the following?

Asthma
diabetes
Epilepsy
Migraines
Other
None

Details

If so, please let us know if your child needs medication during the camp.

***Fill only if we have to give medication to your child during the camp*** With the following, I authorize the Centre Nautique Pierre Plouffe to give (name of medication and doses) in the (morning, afternoon, over lunch) I will also make sure that the required medication is always in my child possession in (let us know where, backpack, lunchbox,etc.).

Writing your name here will act as a signature for the authorization above

Allergies

Does your child have allergies? (Only check the applicable ones)

Hay fever
Insect bites
Medication
Food allergies
Other
None

Details please

Does your child have a dose of adrenaline (Epipen, Ana-Kit) available to them due to their allergies?

yes
no

I hereby authorize the persons designated by the Center Nautique Pierre Plouffe Day Camp to give my child a dose of adrenaline. I also make sure that this dose of adrenaline is always in the possession of my child in __________________ (where it will be).

Enter your name as your signature for the authorization above

Sunscreen

Do you accept that your child's animator helps him to put on sunscreen spray (and if not, then your child will not have sunscreen where he is not able to put it on. )

yes
no

Enter your name as your signature for the authorization above

Date

Parents informations

Name *

First

Last

Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Cellphone number

Emergency phone

Hotel & room number (if applicable)

E-mail *

Payment

We need a credit card in order to take a deposit to secure your child registration to the camp.

Please let us know at what number we can reach you to obtain the credit card number.

RATES

Request for a reservation

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Pierre Plouffe
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Our Location

2900, Chemin du Village

Mont-Tremblant

Qc, Canada, J8E 1E9

info@tremblantnautique.com

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