Rocky Railway VBS Registration 2020
Date: July 20-24
Time: 9am-4:30pm Campers my begin arriving at 8:30am. All campers should be picked up no later than 4:30pm. (Please request earlier or later times as needed)
Ages: 5-11 (entering SK to grade 6 in September 2020)
Cost: Early bird $125 per child by May 31 (payment must be made by May 31 in order to qualify). After May 31, $145 per child
Parent/Guardian Name *
Your answer
Child's Name *
Your answer
Birth Date *
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Grade (entering in September 2020) *
Your answer
Street Address *
Your answer
City *
Your answer
Postal Code *
Your answer
Best phone number to contact you during camp hours *
Your answer
Alternate phone number to contact you during camp hours
Your answer
Email *
Your answer
Name(s) of Emergency Contact *
Your answer
Phone Number(s) of Emergency Contact *
Your answer
I authorize the following people to pick up my child (they may be asked to show photo ID) *
Your answer
I would like earlier drop off/later pick up. Please describe:
Your answer
If possible, I would like to be in the same group as...
Your answer
I give permission for my child to be photographed for the purpose of promotion and programming *
I would like to be considered for financial assistance
Health Card Number: *
Your answer
In the event that the child named above suffers an accident during the activities of an event run by First Baptist Church, I acknowledge that the Church has made effort to ensure safety, and therefore, I do not hold the Director of the VBS Camp or the volunteers of the Church and its members responsible. I further authorize the administration to provide first aid in the case of a medical emergency. I authorize the adult volunteers of First Baptist Church to act as agents for the undersigned to transport in a private vehicle/taxi/emergency response vehicle this child to a healthcare facility and seek appropriate medical care from the required healthcare providers as registered by the Ontario Medical Association. I further release from liability First Baptist Church, Guelph and any of its leaders/volunteers, in the event of an accident en route, during and returning from trips and/or activities associated with the day camp. This agreement does not apply to claims for intentional misconduct and/or gross negligence. I have read and agree to this statement: *
Your name (this will act as your signature) *
Your answer
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This form was created inside of CBOQ Canada Central Association.