Jr Youth Camp Registration
Event Timing: July 1-6, 2018
Event Address: 2478 Creighton Valley Rd, Cherryville, BC V0E 2G3
Contact us at (778)930-0201, Denis@coldstreacmchurch.com
Email address *
Name of camper, first and last *
Your answer
Address
Your answer
Phone number *
Your answer
Age, and birthday *
MM
/
DD
/
YYYY
Gender *
Required
What days will you attend? *
Required
Dietary restrictions *
Allergies if any *
Your answer
Family Doctor
Your answer
Medical Number
Church connected with (if any) *
Your answer
Parent(s) or Guardian, Names and address if different from above *
Your answer
Parent(s) Names and address if different from above
Your answer
Emergency contact, and phone number *
Your answer
I understand that I will have to pay $50 for my child to attend camp,
If you wish to make an online payment, we will be accepting email transfer at stumpmom@gmail.com *
Required
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