2018 HANLEY Choir Camp Registration Form
MONDAY, JULY 9 - FRIDAY, JULY 13 at HANLEY LUTHERAN CHURCH (307 Washington Avenue) from 9:00 - 12:00 noon
There will be a concert for friends and family at Hanley Lutheran Church on Friday, July 13 at 1:00 pm.
Email address *
CAMPER INFORMATION
Camper's LAST Name: *
Your answer
Camper's FIRST Name: *
Your answer
Camper's Main Address: *
Your answer
Age *
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Music Background:
Your answer
Taking music lessons:
Please select if you identify with:
This family has already registered the following child(ren) for the camp:
Your answer
PARENT/GUARDIAN INFORMATION
Parent/Guardian Contact Name: *
Your answer
Parent/Guardian's Contact Numbers: *
Your answer
Relationship to Child: *
Your answer
Parent/Guardian's Email (account checked daily): *
Your answer
EMERGENCY CONTACT INFORMATION
In case of an emergency, if we can't reach the main parent contact, who would you like us to contact?
Emergency Contact Name (First and Last Name): *
Your answer
Emergency Contact Numbers: *
Your answer
Relationship to Child: *
Your answer
MEDICAL INFORMATION
NOTE: It is the responsibility of each camper to bring his/her own medications if required. If there are any treatments or medications required to be administered by a staff member, please provide written instructions from your doctor.
Camper Health Card Number: *
Your answer
Does this child have any special medical requirements? *
If yes, please explain:
Your answer
Does this child have allergies? *
If yes, please list and explain necessary treatment if required:
Your answer
PERMISSION FORM
This is to certify that the above information is complete to the best of my/our knowledge. I/We hereby, for myself, my heirs, executors and administrators, waive and release any and all claims and damages we may have against the Saskatchewan Choral Federation and/or SaskCulture Inc., the Hanley District Community Choir, the Hanley Lutheran Church and any and all sponsors, partners and related contractors for any and all injuries which this child may suffer due to carelessness or irresponsibility on the part of the camper or visitors. Furthermore, we authorize the staff to administer any emergency first aid that is required and to act in loco parentis.
By clicking Yes, I hereby agree to these terms and conditions: *
*
MM
/
DD
/
YYYY
Further, I give permission for pictures and/or videos to be taken of my child throughout the camp and used to promote the camp for future years. *
IMPORTANT INFORMATION
An invoice will be sent to the email provided at the beginning of this form. Payment must be made in full before your child(ren) will be guaranteed a spot at Camp. Payment can be made by credit card or e-transfer. Details will be provided with the invoice.

A minimum of 12 registrations must be confirmed for the Camp to be offered.

Submit
Never submit passwords through Google Forms.
reCAPTCHA
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms