Registration form

Applicant Information
First Name
Family Name
Email
Gender
- Male
- Female
Birthdate
Month
Day
Year
Place of Birth
Nationality
Citizenship
Arrival Date
Hidden
Arrival date
Month
Day
Year
Hidden
Departure
Month
Day
Year
Current Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Guardian Information
Guardian 1
First Last
Relationship
Phone
Email
Guardian 2
First Last
Relationship
Phone
Email
Medical Information
Does the participant suffer from medical problems?
- Yes
- No
If yes, please describe
Program Information
Please select the program you wish to enroll in as well as any of the optional tours. Payment will not be processed at this time, but rather we will contact you with payment details.
Select Program Duration
- 2 Week Program
- 3 Week Program
- 4 Week Program
Additional options
- Toronto/Niagara Fall Tour
Total
$ 0.00 CAD
Important Information on the Payment Process
1. The prices are only for Canadian Citizens. For International Campers – please contact info@destination-canada.ca for an alternative pricing.
2. A deposit is of $500 USD is required to secure your child’s enrollment.
3. Full payment is required by June 1.
4. All payments are 100% refundable.
5. Payments can be made by cheque or International Bank Wire Transfer. (please contact inscriptions@camppilgrim.ca for more information on payment process).
6. The program pricing outlined above does not include laundry services and certain optional off-campus activities (from $25 CAN to $50 CAN per week).
Guardians: Acceptance and Permission
By inputting your name below you hereby agree to permit the camp doctor or nurse to administer such routine medication as they deem advisable in the event of an emergency. If camp doctors are not able to contact either parent, the directors are hereby given permission to act on parent’s behalf in signing permission for medical care as advised by a medical doctor.
Fullname
Date
Month
Day
Year
Phone
This field is for validation purposes and should be left unchanged.

“Day after day I had the chance to practice my English not only inside the classroom but also during the extracurricular activities such as visits to museums, city tours, sports and evening activities. This is an unforgettable experience which I totally recommend…"

- Maria Fernanda Valderrama Vargas, Bucaramanga, Colombia

"Destination Canada was an unforgettable experience. From the moment I arrived, every waking hour was spent having fun and learning English. I spent three weeks meeting students from other countries and going on fantastic excursions to Canadian highlights…"

- Joshua Resendiz – Queretaro, Mexico

"The best thing about the program is the diversity of the student population. The students come from all over the world and it is great to learn about their way of life and culture. I also really enjoyed learning about Canada and its customs and traditions…"

- Katrine Dige Ouesen, Denmark

“I really want to thank Destination Canada for helping me perfect my English language skills over the past 3 years. This has been an unforgettable experience and I would recommend this program to anyone who wants to improve their English language skills…"

- William Deshaies-Petitclerc, Québec