Registration Form
Kids Zone Day Camps 2017 | www.kidszonecamp.ca

To complete registration and ensure your discount and child's spot in camp complete the following 3 things. Registration is NOT complete until
1. Online registration form completed (Below)
2. Waiver - download, print, sign and email to secretary@churchinthevalley
3. Payment received by calling 604-514-8335

Email address
First Camper's Full Name (Last, First)
Your answer
Gender
First Camper's Date of birth
MM
/
DD
/
YYYY
What camp(s) are you registering for? (For the first camper)
Required
Camper's T-shirt size (we need this to get you that free T-shirt we promised you. Please note that sizes are in youth not adult)
Will this child require extended care for a flat fee of $50? Extended care is from 8-9am and 4-5:30pm. Camp time is from 9am-4pm, with registration opening at 9am. Late pickups will be charged $1/min according to our clock.
BC Care Card Number (or copy of Medical insurance)
Your answer
Date of last Tetanus Immunization(day/month/year)
Your answer
Please list any illnesses, injuries and/or hospitalizations the camper has had in the past year
Your answer
Are there any activities that your child is restricted from doing for medical reasons?
If yes please explain:
Your answer
Please list any allergies this child has
Your answer
Does your child have any behavioural special needs like ADD, ADHD.... Please explain:
Your answer
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