Kootenay Covenant Bible Camp - Registration Form 2018
Camp is July 8, 2018 to July 13, 2018
Email address *
Camper Information:
Camper First Name: *
Your answer
Camper Last Name: *
Your answer
Birth Date: *
Campers must be between the ages of 8 and 12 by September 30 of this year.
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Gender *
Health Concerns / Allergies / Medications: *
Your answer
Camper Health Care number: *
Very important in case of medical emergency.
Your answer
A Cabin Mate Request:
Please limit your request to one friend - this is just a request and is not guaranteed.
Your answer
Parent or Guardian Contact:
Parent or Guardian Name: *
Your answer
Phone Number *
Please use the number most likely to reach you.
Your answer
Alternate Phone Number
Your answer
Email Contact: *
Please use an email address you check, so we can send you important information.
Your answer
Full Mailing Address: *
Please include your Postal Code
Your answer
Church affiliation if any:
Your answer
Emergency Contact:
(If different than above)
Emergency Contact Name: *
Your answer
Emergency Phone: *
Your answer
To be released to: *
(Name of person child can leave with)
Your answer
Will you be paying with Online? *
Required
All campers this year will be provided with a water bottle and a T-shirt. What size shirt for this camper? Please Check Youth or Adult then the size. *
Required
Parent agrees with the Camp Policies and Procedures *
Parental/Legal Guardian Consent and Medical Release: My agreeing to this form indicates the above named person has permission to engage in all camp activities, on and off camp grounds, to be transported, and to participate in outings and field trips off Kootenay Covenant Bible Camp (KCBC) grounds, except as noted. (This completed form may be photocopied for trips out of camp.) I support the camp administration in enforcing camp rules and accept responsibility for payment of property damaged by my child. I understand that my child could be sent home if she/he becomes a hazard to the safety and the rights of others, has appeared to have rejected the reasonable controls of camp, or has been found with a prohibited substance. I will speak directly to the Camp Director before removing my child, at anytime, from the camp grounds. I authorize the dispensing of medications that accompany my child and the dispensing of common over-the counter medications that might be needed. I give the camp personnel the authority to act on my behalf in case of an emergency, including medical treatment. (Parent/Guardian will be notified as soon as possible). I understand that I am financial responsible for costs incurred. I agree to the release of any records necessary for insurance purposes. I hereby release KCBC and its personnel from all claims for damages arising from any accident or injury caused by my child’s participation in the camp program. I give permission for my child’s picture to be used in KCBC publications and promotions and the use of the email address to be used only for KCBC communication to you the parent or Guardian.
Required
Camper Agrees to the Terms *
The agreement below must be signed by each individual camper and by his/her parents or legal guardian. Our Promise To You The Director and Leaders of Kootenay Covenant Bible Camp promise to provide a safe place for the growth of the whole person. Our effort will be to generate a physical, social and spiritual atmosphere that is nurturing, creative, and joyful. Our focus will be to stimulate an environment in which the Holy Spirit can work. Your Commitment To Us I recognize that KCBC is a Christian camp and that my behaviour, language, dress and attitudes will be encouraged in the direction of developing a Christ-like character. As a camper, I promise to treat the camp leaders and staff with respect and to abide by their decisions and guidelines for the week. I will obey all camp curfews and will not leave the grounds or enter the lake without permission. I understand that the use of tobacco, alcohol, and illegal drugs are not permitted at camp and that all prescription drugs must be handed in to the camp First-Aid person. I also will not bring prohibited items to camp. Where possible I promise to participate in all scheduled camp activities and cooperate with energy and enthusiasm. I promise to respect and enjoy my fellow campers and avoid hurting them physically or by verbal ridicule. I understand that failure to keep the above promise could mean that I will be sent home early, forfeiting all of the camp fees that have been paid. My signature indicates that I understand and accept the above agreement and will conduct my behaviour according to the terms of this agreement.
Required
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