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TVBC Jr. Camp Registration (Ages 10-12)
Jr. Camp; Ages 10-12; July 23rd - 28th
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Email
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Your email
If your camper is registered BEFORE June 1st, you will receive $10.00 off of the total camp fee for the summer.
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By checking this box I confirm that I have read the above statement.
Required
Camper's First & Last Name
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Your answer
Male or Female
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Male
Female
Camper's Date of Birth
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MM
/
DD
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YYYY
Camper's Age
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10
11
12
Other:
Required
Address
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Your answer
City, Province
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Your answer
Postal Code
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Your answer
Home Phone
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Your answer
Work/Cell Phone
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Your answer
Emergency Contact
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Your answer
Emergency Contact's Phone
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Your answer
Relationship of Emergency Contact to Camper
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Your answer
Camper's Med. #
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Your answer
Expiration Date of Camper's Medicare
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MM
/
DD
/
YYYY
Please List Known Allergies
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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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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
I, the parent/guardian of this camper, grant Tay Valley Bible Camp permission to take my camper's picture and allow use of any pictures taken of my camper in Tay Valley Bible Camp promotional material.
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I agree to this statement
I disagree to this statement
Required
I, the camper, will respect the rules and facilities of Tay Valley Bible Camp. I am aware that any unacceptable behavior may result in dismissal from camp without refund of fees.
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I have read the statement(s) above carefully and AGREE to what is stated.
I have read the statement(s) above carefully and DISAGREE to this statement
Required
I, the parent/guardian, give my camper permission for off site special activities. (This may include, but is not limited to hiking.)
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I have read the statement above carefully and AGREE to what is stated.
I have read the statement above carefully and DISAGREE to what is stated.
Required
Attention returning campers: Receive $10.00 off your camp fee for each new camper you bring to camp. Teens can also earn credits towards their camp fee by coming to workdays.
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By checking this box I confirm that I have read the above statement.
Required
Please list any discounts your believe your child has earned through workdays or inviting friends.
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Your answer
I am aware that the standard fee for 1 week of Jr. Camp is $150.00
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By checking this box I confirm that I have read the above statement.
Required
Please specify preferred method of payment.
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Cheque/Money Order mailed to "Tay Valley Bible Camp, 115 Moss Ave. Fredericton, NB E3A 2G2"
Cash, Cheque, or Money Order upon arrival
Pay online with Credit/Debit Card upon receiving an invoice via email
Required
Please specify who will be picking up your camper at the end of their camp week.
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Your answer
Please enter the first and last name of the parent/guardian who completed this registration form.
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Your answer
Please enter any questions, comments, or concerns you may have and we will respond to you via the email you have provided at the top of this form.
Your answer
Send me a copy of my responses.
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