VBS 2019 - ROAR
Email address *
August 12th - 16th, 2019
Join us each day from 8:30am-4:30pm. Camp is open to all kids age 4+.
Life is wild. God is good.
Registration
Child's Name *
Your answer
My child is: *
Child's birth date *
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DD
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Grade entering in September
T-shirt size
Allergies / Medical Concerns / Special Considerations
Is there anything else we should know about your child?
Your answer
Provincial Health Card number
Your answer
Family Doctor (name and phone number) *
Your answer
The cost for each child is $50 for the week. *
If dropping payment off at the church, please be sure it's clearly marked with the child's name.
Photo permissions *
Please note names are never published.
Required
Consent, Waiver & Medical Release
St. Andrew's follows the policy of Leading With Care as laid out by the Presbyterian Church in Canada. Details on the church's Leading With Care policy are available at http://presbyterian.ca/leading-with-care.

In the event of accident or sickness, I release St. Andrew’s Presbyterian Church in Ottawa, its staff and volunteers from any liability, claims and causes of action by reason of any injury which may be sustained as a result of this activity, whether on Church premises or on the way to or from, or while at any activity or event during the week of camp.
In the event of an emergency or injury requiring medical attention, I authorize treatment for the participant.
I understand that reasonable attempts will be made to contact me, should such a situation occur. In the event when I cannot be reached, I give St. Andrew’s Presbyterian Church’s staff and/or volunteers permission to seek medical attention for my child. If the above designated physician is not available or the situation warrants, I give permission to the physician, paramedic, nurse, or dentist selected by St. Andrew’s Church representative to provide medical or dental aid for the illness or injury including transportation to and from facilities. I agree to bear all costs associated with medical care and transportation.

Parent Signature *
Typing your name below is your electonic signature to the above.
Your answer
Family information
Parent/Guardian names *
Your answer
Phone number *
Your answer
Address
Your answer
Email address
Your answer
May we send you occasional emails from the church?
Emergency Contact information
Name of emergency contact
If parents are unavailable.
Your answer
Relation to child?
Your answer
Phone number of emergency contact
Feel free to provide more than one contact phone number
Your answer
Anything else we should know to reach the emergency contact?
Your answer
Morning & Afternoon Childcare
Summer Camp begins at 9am and finishes at 3pm. Extra hours childcare is available for $5/session per child.
Do you need childcare before or after the summer camp program? *
Required
Anything else we should know about after hours childcare?
Your answer
Name of person(s) authorized to pick up child in the afternoon *
Your answer
Relation to child?
Your answer
Phone number(s) of person picking up your child *
Your answer
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