Summer Camp at Eastview Community Center

Welcome! Please complete the form to register you child/children in the form below.

The Summer Camp with be held at the Eastveiw Community Centre: 615 6th Ave, Regina, SK

10 places are held for Regina Community Clinic children free of charge.

Parent Name (Please type full name) *

Your email address *

Your Phone Number (000-000-0000) *

1st Child - Full name and Age *

2nd Child - Full name and Age

3rd Child - Full name and Age

Permission: Yes or No *

Please describe:

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