2017 Granville Chapel Retreat Registration
September 15-17, 2017 at Stillwood Camp, Cultus Lake, BC

Please read ALL the following instructions before registering:

One registration form must be completed per family. A family consists of parent(s) and children up to and including post secondary students who are related by biology, adoption or marriage. All minors (under 18) attending the retreat MUST BE ACCOMPANIED BY AN ADULT who is over the age of 21.

If minors are coming with another family or an adult other than their parent, they should register as a single applicant and pay the appropriate fee based on their age category (Info in Section 4). Minors MUST ALSO COMPLETE a PARENTAL CONSENT AND LIABILITY WAIVER to be signed by their parent(s) or guardian(s). This form can be found at the Connect Point or on the homepage of our church website.

FOOD AND ALLERGIES: Please indicate whether you have any serious or life threatening allergies or medical conditions in the Allergy/Medical Section below. (i.e.: anaphylaxis to foods or insects, lactose or gluten intolerance, or significant medical conditions). Clearly state the type of reaction and medical response required. The Kitchen Staff at Stillwood will contact you regarding dietary needs for those with significant issues.

It is expected that those with allergies and medical needs come to camp with appropriate medication for their condition.

Those on a vegetarian diet will find the variety of foods plentiful. Those on a vegan diet should indicate and speak to Stillwood staff upon arrival. Due to food safety regulation NO food or drink is allowed to be brought into the camp.

Family (Last) Name
Your answer
Adult #1
Enter the first and last name of an adult registering for the retreat.
Your answer
Adult #1 Status
Adult #1 Allergies & Medical Needs
List food allergies and any other significant allergies, severity, and treatment plan (ie. is epinephrine required). Please indicate if you have any medical conditions we should be aware of
Your answer
Adult #2
Enter the first and last name of a second adult registering for the retreat. Leave blank if not applicable
Your answer
Adult #2 Status
Adult #2 Allergies & Medical Needs
List food allergies and any other significant allergies, severity, and treatment plan (i.e. is epinephrine required). Please indicate if you have any medical conditions we should be aware of
Your answer
Child #1
Enter the first name of a child registering for the retreat. Leave blank if not applicable.
Your answer
Child #1 Age
Your answer
Child #1 Grade
Enter your child's grade. If not in school, then indicate preschool or post secondary student.
Your answer
Child #1 Allergies & Medical Needs
List food allergies and any other significant allergies, severity, and treatment plan (i.e. is epinephrine required). Please indicate if this person has any medical conditions we should be aware of
Your answer
Child #2
Enter the first name of a child registering for the retreat. Leave blank if not applicable.
Your answer
Child #2 Age
Your answer
Child #2 Grade
Enter your child's grade. If not in school, then indicate preschool or post secondary student.
Your answer
Child #2 Allergies & Medical Needs
List food allergies and any other significant allergies, severity, and treatment plan (i.e. is epinephrine required). Please indicate if this person has any medical conditions we should be aware of
Your answer
Child #3
Enter the first name of a child registering for the retreat. Leave blank if not applicable.
Your answer
Child #3 Age
Your answer
Child #3 Grade
Enter your child's grade. If not in school, then indicate preschool or post secondary student.
Your answer
Child #3 Allergies & Medical Needs
List food allergies and any other significant allergies, severity, and treatment plan (i.e. is epinephrine required). Please indicate if this person has any medical conditions we should be aware of
Your answer
Child #4
Enter the first name of a child registering for the retreat. Leave blank if not applicable.
Your answer
Child #4 Age
Your answer
Child #4 Grade
Enter your child's grade. If not in school, then indicate preschool or post secondary student.
Your answer
Child #4 Allergies & Medical Needs
List food allergies and any other significant allergies, severity, and treatment plan (i.e. is epinephrine required). Please indicate if this person has any medical conditions we should be aware of
Your answer
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