---Young Adult Retreat Registration--- (Age 19-35)
Event Timing: May 17th-19th, 2019
Event Address: West Bank Bible Camp
Contact us at wbbcamp@gmail.com or 306-773-6815
PURPOSE & EXTENT OF REGISTRATION FORM: West Bank Bible Camp, is collecting and retaining this personal information for the purpose of enrolling the attendee in our event, and to inform you of any program updates. This information will be maintained confidentially and indefinitely as it is a requirement of our insurance company and legal counsel. If you wish West Bank Bible Camp to limit the information collected, please contact us ASAP at 306-773-6815
ATTENDEE INFORMATION
Name (First & Last) *
Your answer
Cell #: (###-###-####)
Your answer
Attendee Email Address: *
Your answer
Attendee Health Care Number (enter without dashes): *
Your answer
Attendee Birthdate: (Age 19-35) *
MM
/
DD
/
YYYY
Home Church (If Applicable)
Your answer
EMERGENCY CONTACT INFORMATION
Emergency Contact (First & Last Name): *
Your answer
Emergency Contact Phone Number: (###-###-####) *
Your answer
Relationship to Attendee *
Your answer
Please disclose all medical or health conditions and allergies of which camp staff should be aware of:
Your answer
List food allergies and severity of reaction
Your answer
Forms & Payment
Once you have submitted this registration, we will email you our Medical Form and Assumption of Risk form for the weekend.
I understand that in order to attend this event I must fill in an "Assumption of Risk" Form. *
Required
I understand that I will have to pay $60 upon arrival to cover the costs of the weekend *
Required
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