Squirt Grades 2 & 3 « Covenant Bay Bible Camp

Squirt Grades 2 & 3

Squirt Camp

Grades 2 & 3 - July 22-24, 2010
First Name(required)
Last Name(required)
Email(valid email required)
Phone(required)
Address(required)
City(required)
Province or State(required)
PC or Zip(required)
Parent's Work Number
Emergency Phone Number(required)
Birthdate mm/dd/yyyy(required)
Grade Completed(required)
Gender
Female
Male
What is the name of your church? (If you are not part of a church just leave the space blank)
Parents or Guardian(required)
Where would you prefer to stay?
Cabin
Tent
Desired Cabin Partner
Health Care Number(required)
Special Medical Conditions or Medications
Will this be the first time you have been at a Covenant Bay Bible Camp?
Yes
No
How did you find out about the camp?
Will you bring cookies or squares to help with snack time?
Yes
No
The above named has my permission to attend camp. I/We understand that the camp environment and activities pose risks to personal health and safety, including the particular risks in waterfront activities. I/We hereby agree to hold blameless the Covenant Bay Bible Camp Society and the Evangelical Covenant Church of Canada and the staff in the event of injury at camp. I/We give consent for medical care in the event of injury or illness. I/We the Parent(s)/Legal Guardian(s) of the above named Camper have read and understand the above agreement and are in agreement with it. The information we have provided on this form is truthful to the best of our knowledge.
Check here if you have read and agree to the above statement
How do you plan on paying for your registration?(required)
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