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Kids' Summer Camp Registration Form 2026
Breslau Mennonite Church
226 Woolwich Street South Breslau, ON N0B 1M0 (519) 648-2501

We are excited to be back together at Breslau Mennonite Church's Summer Camp!

Register early to secure your spot as we will have a cap on registration based on the number of children our facility can support. We are so excited to have a fun and safe summer together.

Date: August 10th-14th, 2026
Drop Off: 8:45 - 9:00 am
Pick Up: 12:00 pm

Children must be at least 5 years old by August 10, 2026 and not older than 12 years old on December 31, 2026.

Interested in volunteering? Email us at bmcsummercamp@breslaumc.ca
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Camper Information
First Name *
Last Name *
Grade Entering in September 2026 *
Date of Birth *
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DD
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Health Card Number *
Address *
Parent/Guardian Name *
Phone Number *
Cell Phone Number
Email Address
Name of Parent/Guardian
Phone Number
Cell Phone Number
Email Address
Are you a returning camper? *
Emergency Contact if different from Parent/Guardian *
Name *
Phone *
Medical Information
Does your child have any severe allergies or medical conditions?   (i.e. bee stings, food, penicillin, or latex)? *
If Yes, Explain
Does your child carry an Epipen or Inhaler? *
Is there anything else that we should know about your child to help make camp a positive experience for them and other campers? (eg. do they require extra support in school, strategies that are helpful when they are upset) *
Breslau Mennonite Church Safe Place Guidelines
All leaders follow BMC’s Safeplace Guidelines. You can read BMC's Safeplace Guidelines here.
Photo and Video Release
I give permission for photos and videos to be taken of my child while at the Breslau Mennonite Church Summer Camp, August 10-14, 2026. I understand that the photos and videos will be used for slide shows inside the church, for archival purposes, and for promotional materials.
 *
I/we, the parents or guardians named above, authorize the ministry staff of Breslau Mennonite Church to sign consent for medical treatment and to authorize any physician or hospital to provide medical assessment, treatment or procedures for the participant named above.

I/we, the parents or guardians named above, undertake and agree to indemnify and hold blameless the Ministry staff, Breslau Mennonite Church, its Pastors and Elders from and against any loss, damage or injury suffered by the participant as a result of being part of the activities of the Breslau Mennonite Church, as well as of any medical treatment authorized by the supervising individuals representing the church. This consent and authorization is effective only when participating in or traveling to events of the Breslau Mennonite Church Kids’ Summer Camp August 10-14, 2026
  *
Would you like to receive other communications from the Church regarding children's programs (i.e. musicals, choirs, and special camp Sundays)? *
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