Camper Inquiry Form

For more information and to receive our complete camper application package via mail, please complete the following form in full.

You may also download the camper application package here. Please complete the form in full and mail to the address on the form.

Parent Information
First name: *
Last name: *
Address: *
City: *
Province/State: *
Postal Code: *
Day Phone:
Night Phone: *
Email Address: *

Child Information
First name: *
Last name:
Age: *

Child #2 Information
First name:
Last name:
Age:

Please tell us about any special needs your child has (eg. learning disabilities, ADHD, eating or sleeping disorder, bedwetting or incontinence etc.)
Please enter the verification code into the box below to submit the form.
Code: *
* required fields

When our son Kyle was age 7, he had already experienced more challenges than any child that age should have to endure......

• From Dianne and George, Kyle's parents

Thank you very much for allowing me to go to Camp Kirk....

• from Michael, a camper in 2007

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Toll Free: 1-866-982-3310 \| Phone: 416.782.3310		Copyright © 2005 Camp Kirk

Camper Inquiry Form

Parent Information

Child Information

Child #2 Information