Registration Form: Spring Break Camp 2020
Adventures at Sea/Cooking Camp: March 23-27, 2020
Email address *
Child's Name *
Child's Age *
Child's date of birth: *
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Name of Parent: *
Parent's Primary Phone number: *
Parent's cell phone number:
Home Address: *
City: *
Postal Code: *
Does your child have any allergies or other medical conditions? *
If yes, please detail here:
Please provide us with any information about your child that will assist us in creating their best camp experience:
In case of emergency, please provide us with the name of a person we can contact: *
Phone number: *
Relationship to child: *
Child's Family Doctor: *
Family Doctor Phone Number: *
How will you be sending the $75 fee? (Fee is per child. Please make all cheques payable to Burnaby North Baptist Church.) *
Do you have other children participating in the camp? If yes, please provide their names here. (A registration form and fee must be received for each child.)
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