1. Type your billing information on this form exactly as it appears on your credit card statement2. Print out this form3. Sign4. Fax this form to us at: 1-514-313-5453 (or scan it, and send it to us as an attached file)5. Continue to Confirmation Page (by clicking on the blue button below the form)
Camper’s name
Cardholder’s name as it appears on Credit Card
Billing Address (as shown on credit card statement):
Card number
Credit Card Expiry Date
Month1 - January2 - February3 - March4 - April5 - May6 - June7 - July8 - August9 - September10 - October11 - November12 - December
To reserve the sessions you have selected a CAD $ 250 deposit (deductible but not reimbursable) is required for each camper and six weeks prior to arrival, at least 50% of the total amount invoiced must be paid. Please note that if this payment (at least 50% of the total due) is not received by the due date, your reservation will be automatically cancelled without any right to a reimbursement of the registration fee. If payment is made in cash or with a credit card, the second payment may be made upon arrival.I authorize Ekocamp to charge CAD $ to my credit card as payment for my child's at camp. I have read, understood and approved the Parent's handbook and Ekocamp's refund policy .
Signature of cardholder
Payment can also be made with a Bank Transfer
