Evolution Mining
Red Lake Operation

RECREATION CENTRE

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DAYCAMP REGISTRATION FORM

Parent First Name

Parent Last Name

Email

Home Phone Number

Work Phone Number

Address

Alternative Contact 1

Alt. Contact 1 Phone #

Alternative Contact 2

Alt. Contact 2 Phone #

The following people have permission to pick up my child (children).

Child's Name

Child's Date of Birth

Medical Information/Allergies

Child's Name

Child's Date of Birth

Medical Information/Allergies

Child's Name

Child's Date of Birth

Medical Information/Allergies

If you experience any issues with your registration, please email gwyneth.carlson@evolutionmining.com