CIT Registration Form Teen's InformationCIT program is offered to members only and free of charge for children 15-16First Name* Family Name* Age* Please enter a value between 15 and 16 (by September 30th,)Grade completed by June 2023* Email* Phone Number* Your preferred area of activities* day camp sailing waterfront tennis open to all I would like to register in the CIT Program for the following weeksweeks* (1) June 19 - June 23 (2) June 26 - June 30 (3) July 3 - July 7 (4) July 10 - July 14 (5) July 17 - July 21 (6) July 24 - July 28 (7) July 31 - Aug. 4 (8) Aug. 7 - Aug. 11 (9) Aug. 14 - Aug. 18 QualificationsSpoken languages* English French Other ______________________________________________ Relevant experienceConditions or Concerns(Parents are responsible for informing the BLBC manager of any special conditions or precautions.)Teen's Medicare Number* Province of medicaire* Allergies*Medical conditions*Parent's InformationParent name (1)* First name, Last name Email* Confirm email Parent name (2) First Name, Last Name Spouse email Phone number to use during camp time* Primary phone number (home) Primary Address (home)* Street Address, City, Postal Code (home) Country phone number (home) Country address (home) Street Address, City, Postal Code (country) Other phone numbers (cell, work)* Please provide the names and numbers of 2 other people (besides parents) to contact in case of emergencyName (1st Contact)* First Name, Last NameRelation (1st Contact)* Phone Number (1st Contact)* Name (2nd Contact)* First Name, Last NameRelation (2nd Contact) Phone Number (2nd Contact)* Comments Δ