MY Camp Registration
Date: Aug 30th - Sept 2nd 2018
Location: Ontario Educational Leadership Centre
Cost: $250
Email address *
Personal Information
First Name *
Your answer
Last Name *
Your answer
Gender *
Age *
Shirt Size *
Health Card Number *
Your answer
Any Medical Concerns We Should Be Aware Of
Your answer
Contact Information
Email Address *
Your answer
Phone Number *
Your answer
Address
Street Address *
Your answer
City *
Your answer
Province / State *
Your answer
Postal Code *
Your answer
Country *
Your answer
Emergency Contact Information
Name *
Your answer
Phone Number *
Your answer
Preferred Payment Method
You can make a payment in Cash or Cheque. Please mention payment is for Youth Camp 2017
You can make a payment via Credit Card by calling 647-907-7214
Payment Method *
Disclaimer *I the undersigned, hereby take full responsibility for any injury of whatsoever nature which may occur to my person while attending any and all events organized by Council Of Islamic Guidance. I Hereby release Council Of Islamic Guidance and its organizers from any liability in the event of any injury and/or illness whatsoever caused to my person, damage or theft to my possessions or personal property that may occur before, during and after any all events organized by Council Of Islamic Guidance. I further agree to indemnify Council Of Islamic Guidance, its organizers for any claims which may be brought against it in any respect thereof in respect of any action or omission on my part. I hereby undertake and agree to follow all rules, regulations and directives of Council Of Islamic Guidance and its organizers both oral and written. I further confirm that I have fully understood the foregoing and am of legal age to sign this Release and Indemnity. Upon signature, I agree that I have read and understood all the information provided within the Registration form & Information Brochure. *
A copy of your responses will be emailed to the address you provided.
Submit
Never submit passwords through Google Forms.
reCAPTCHA
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service