Johnston Heights Youth Summer Camp 2018
When: August 26th - Sept. 1st, 2018
Where: Eagle Bay Camp, 5055 Eagle Bay Rd, Eagle Bay, BC V0E 1T0


Early Bird(Before June 1st): $320

Regular: $360

Late(After July 15th): $400

Transportation: $50

Contact: Jon at (778) 348-0670 or

Email address *
Camper Name *
Upload Recent Picture of Camper *
Age *
Grade as of Sept. 2018 *
Gender (Birth) *
Student Email *
Student Phone Number *
Guardian Name *
Guardian Phone Number *
Emergency Contact(Can be the same as Guardian). *
Emergency Contact Phone Number *
Please list and describe any medications the camper is currently using or have used in the last year.
Please describe any medical conditions the camper currently has.
BC Care Card Number *
Dietary Restrictions *
Student will ride the Bus to camp. Additional cost of $50. *
How did you hear about Camp? *
Payment Options *
STATEMENT OF PARENT/GUARDIAN Permission Form, Privacy Policy, Release Waiver & Assumption of Risk.
My child has permission to attend Johnston Heights “Navigate” camp from August 26th - September 1, 2018. I am sure that the Johnston Heights Church Youth Staff will do their best to give my child the necessary support and supervision needed and I understand that safety and health rules will be observed. I hereby give JHY camp personnel the authority to act on my behalf in case of emergency, including medical treatment(whereby the parent/guardian will be notified as soon as possible), and I understand that I am financially responsible for any costs incurred. When the camp program involves leaving the camp premises (e.g. waterfront, hiking, etc.), I give permission for my child to participate. I hereby release Johnston Heights Church and its personnel from any and all liability and claims for damages arising from any accidents or injury caused by my child’s participation in the camp program including (but not limited to) paintball, climbing tower, tubing, wake boarding, and field games. I understand that Johnston Heights Church respects the privacy of personal information that is submitted to them. I know that Johnston Heights Church collects information only for the purpose of JHC Student Ministries, discloses it to others only as required, and is committed to protecting to the best of their abilities. I understand that Johnston Heights Church assumes that my submission of a registration form represents my consent to collect, use and disclose information. I also give permission to Johnston Heights Church to use photos and videos of my child for presentations and promotional materials.
I have read and accept the conditions of the Statement of Parent/Guardian. *
Financial Aid
If you need Financial Aid to complete your camp payment, forms are available at the JHC office or contact Jon Rendall -
Final comments or questions.
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