REGISTRATION FOR VANCOUVER WEST CAMPS
PERSONAL INFORMATION
First Name  
Last Name  
Parents' Names  
Address  
City  
Province  
Postal Code  
Email  
Home Telephone  
Work Telephone  
Age  
IS THIS YOUR FIRST PROGRAMS WITH ESC? IF NOT-PLS SPECIFY PROGRAM'S NAME AND YEAR  
Health Problems  
Allergies, Requests  

 HINT: All programs below are available. Once a program becomes fully booked, we will remove it from this form!

 3 for 2 2008 (EXPIRES JUNE 15, 2008)
3 for 2 OFFER  
2008 REFERRAL PROGRAM
ENETER LAST 4 DIGITS OF HOME PHONE NUMBER OF THE PERSON WHO REFERRED US TO YOU  
   MTN BIKE CAMPS VANCOUVER WEST
LITTLE RIPPERS 1  
LITTLE RIPPERS 2  
EXTREME RIDERS 1  
EXTREME RIDERS 2  
Rentals for programs
Bike  
Helmet  
Arm Pads  
Leg Pads  
    Camp Services
 
After hours care  
JUNIOR MEMBERSHIP 

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ESC Adventures Inc :: 3642 Point Grey Rd :: Vancouver, British Columbia V5T 4R5 :: Canada :: 1.604.307.2453 :: info@escbc.com
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