Camp Registration Form 2013

CAMPER'S PERSONAL INFORMATION
Child's Name
Address
City
Province
Postal Code
Health Card Number
Sex
Age
Birthdate Month
Birthdate Day
Birthdate Year
Home Church
Roommate #1
Roommate #2
Contact Name
Contact Email
Home Telephone
Work Telephone
CAMP REGISTRATION
Kid's Camp (July 14 to July 19) - ages 7 to 10
Jr. High Camp (July 7 - July 12) - ages 11 to 13
Youth Camp (August 5 to August 11) ages 14 to 19
Young Adult (August 16 to August 18)
MEDICAL INFORMATION
1. Has your child been on regular medication in the past year?
2. Has your child been taken off any medications?
Holidays from medications will NOT be permitted during camp.
3. Is your child bringing any medication to camp?
4. Do you have any allergies?
5. Are there activities your child cannot participate in due to medical reasons?
6. Does your child have a history of surgery or serious illness?
For PROGRAM ONLY please indicate accomodation location:
Cancelling 7 days or more before the start of camp permits a 100% refund (less a $25.00 administration fee). Less than 7 days permits a 50% refund. No cancellations are permitted within 24 hours of the start of Camp (Medical emergencies are the only exception, but are subject to the $25.00 administration fee). Parents of children with special needs who require one-on-one attention need to contact the main office and make arrangements for their children while attending camp programs. We will try our best to match up your child with the room mates provided, but we can not guarantee that they will be in the same room. The camp registrar will be in contact with you within 24-48 hours to confirm the information you have provided. Arrangements for payment will be made at that time.
Payment for early bird registrations must be received by the early bird date.
** Personal cheques WILL NOT be accepted on Registration Day. **

Copyright © 2013; Lakeshore Pentecostal Camp
Eastern Ontario District of the Pentecostal Assemblies of Canada