Camper Inquiry Form

For more information and to receive our complete camper application package via mail, please complete the form below in full. You may also download the Camper Application Package here. Please complete the application in full and mail to the address indicated on the form.

We have and continue to welcome many campers from America and all over the world and we are pleased to arrange for one of our staff to pick-up and return your camper from and to Toronto's International Airport.  Allow your child to enjoy the Camp Kirk experience.  The effect will last a lifetime.

Parent Information

	First Name:*
	Last Name:*
	Address:*
	City:*
	Province/State:*	Select a Province/State -- CANADA -- Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Northwest Territories Nova Scotia Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon Territory -- UNITED STATES -- Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
	Postal Code:*
	Day Phone:
	Night Phone:*
	Email:*

Child #1 Information

	First Name:*
	Last Name:
	Age:*
	Gender:	Male     Female
	Please tell us about any special needs your child has (eg. learning disabilities, ADHD, eating or sleeping disorder, bedwetting or incontinence etc.)

Child #2 Information

	First Name:
	Last Name:
	Age:
	Gender:	Male     Female
	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 below. The code is NOT case-sensitive.*