*
Required
Student's Last Name:
*
required
Student's First Name:
*
required
Student's Date of Birth:
*
required
(dd/mm/yyyy)
Student's Gender:*
Male
Female
Rather not say
Are you a current DSC student?*
Yes
No
Student Number:
(located on your child's student id card and contained in your child's student email address or N/A if non-DSC)
Current School Name:
Where did you hear about the program?*
School Website
Social Media
Search Engine
Referred by Program Partners
All Non DSC students must fill out the
DSC Medical Questionnaire
.
Parent 1 Name:
*
required
Parent 1 Email:
*
required
Parent 1 Contact Number:
*
required
Parent 2 Name:
Parent 2 Email:
Parent 2 Contact Number:
Emergency Contact Name:
*
required
We need an emergency contact if we can't reach Parent 1 and Parent 2. The emergency contact cannot be Parent 1 or Parent 2.
Emergency Contact Email:
*
required
We need an emergency contact if we can't reach Parent 1 and Parent 2. The emergency contact cannot be Parent 1 or Parent 2.
Emergency Contact Number:
*
required
We need an emergency contact if we cannot reach Parent 1 and Parent 2. The emergency contact cannot be Parent 1 or Parent 2.
Winter Program Course Selection
Week 1, Dec 23, 24 & 27
None
Wk 1 Game On Minecraft (Ages 8-10) 9:00-11:00 - $1764
WK 1 Stormy Chefs (Ages 4-7) 9:30-12:00 - $2205
Wk 1 Dec 23 Gingerbread Workshop (Ages 8-17) 10:30-12:30 - $630
Wk 1 Gymnastics (Ages 4-8) 9:00-11:00 - $1103
Wk 1 Science Adventures (Ages 4-7) 9:30- 12:00 - $2205
Wk 1 Soccer (Ages 4-8) 10:30-11:45 - $725
Week 2, Dec 30, 31, Jan, 2, 3
None
Wk 2 Basketball (Ages 9-12) 9:00-10:30 - $1134
Wk 2 Holiday Movie Trailer (Ages 8-11) 10:00-12:30 - $3654
Wk 2 Gymnastics (Ages 4-8) 9:00-11:00 - $1470
Wk 2 Science Adventures (Ages 8-11) 9:30- 12:00 - $2940
Wk 2 Soccer (Ages 9-12) 10:30-12:00- $1092
Wk 2 Jan 2-3 Frosty Lab (Ages 4-5) 10:00-12:00- $1699
Wk 2 Dec 30-31 Winter Art House (Ages 4-5) 10:00-12:00 - $1699
Photos and Videos Consent:
I give permission to take photographs and/or videos of my child in school-related activities and use them in the School's printed and online channels.
Yes
No
Total amount:
Total
Please
stay on the page after you submitted the form
and the Paypal icon will appear automatically, after you
clicked on the icon
, you will be
redirected to the Paypal checkout page
.
Please send a confirmation email to the address below*: