TVBC Junior Camp Registration 2021
* Required
Email address
*
Your email
I, the parent/guardian, have read the COVID-19 statement above.
*
By checking this box I confirm that I have read the COVID-19 statement
Required
I would like to register my camper for:
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Ball Hockey, Ages 7-11 (June 30th - July 2nd)
Ages 7-9 (July 18th - 23rd)
Ages 10-12 (July 25th - 30th)
Required
Camper's First & Last Name
*
Your answer
Male or Female
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Male
Female
Camper's Date of Birth
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MM
/
DD
/
YYYY
Camper's Age
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7
8
9
10
11
12
Other:
Required
Street Address, City, Province, Postal Code
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Your answer
Home Phone
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Your answer
Work/Cell Phone (Parent/Guardian)
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Your answer
Emergency Contact's Name and Relationship to Camper
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In the event of an emergency we will contact the parent/guardian first using the phone numbers submitted above. If we are unable to make contact with the parent/guardian at the phone numbers listed above we will then use the emergency contact listed.
Your answer
Emergency Contact's Phone
*
Your answer
Camper's Med. # and Exp. Date (If from U.S. state health insurance provider)
*
Your answer
Please List Known Allergies
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If there are no known allergies please respond with "N/A"
Your answer
Please list medications and dosages. (Medications must be turned in to registrar upon arrival in their original container with clear written instructions.)
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If there are no medications please respond with "N/A"
Your answer
Please indicate if your child has a history of any of the following:
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Diabetes
Bed Wetting
Sleep Walking
Asthma
Ear/Stomach Aches
Homesickness
Agressiveness
A.D.H.D.
N/A
Other:
Required
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