Registration Form - Galactic Starveyors 2017
If you intend to pay by cheque, please have your cheque details handy before you complete this form. Thank you.
Details of Parent
Name of Parent
Your answer
Relationship to Child / Children
Your answer
Home Address
Your answer
Email Address
Your answer
Mobile Number
Your answer
Home Number
Your answer
Who will pick up your child /children at dismissal time?
Your answer
Name of friend / child's friend who invited you (if any)
Your answer
Please state any medical and/or allergy and/or special needs information for your child/children attending the camp (if any)
Your answer
Details of Child/Children Attending The Camp
Name of Child 1
Your answer
Birth Date
Your answer
Gender
School
Your answer
Name of Child 2
Your answer
Birth Date
Your answer
Gender
School
Your answer
Name of Child 3
Your answer
Birth Date
Your answer
Gender
School
Your answer
RSVP For Family Night Dinner on 24 Nov (Fri)
Will you and/or family be attending the Family Night Dinner?
If you and/or family are able to make it, please state the number of people coming
Your answer
Call For Galactic Help!
Are you interested in volunteering to help us?
Please indicate the areas you are interested to help in (you may choose more than 1)
Payment Details
FOR PAYMENT BY CHEQUE

Please cross your cheque and make it payable to:
Calvary Baptist Church

At the back of the cheque, please write:
- "Galactic Starveyors"
- the name of your child / children
- your mobile number

You can either submit your cheque at the EKC Admin table on Sunday mornings or post it to:
Calvary Baptist Church
48 Wan Tho Avenue
Singapore 347592
Attn: Mavis Chia (EKC)

Payment Amount
$30 / $20 for Early Bird (registration and payment received by 31 Aug 2017)
Your answer
Payment By
Bank and Cheque Number (For Payment By Cheque)
Your answer
Indemnity
I hereby permit my child to participate in the Galactic Starveyors Kids Camp. I agree to indemnify and hold harmless Calvary Baptist Church, their staff and volunteers against all claims arising out of any mishap or injury that may occur in the course of or as a result of my child's participation in the camp's activities.

I give permission for Calvary Baptist Church, their staff and volunteers to take and store photographs and/or video footage of my child to be used in the promotion of any church activities.

In case of emergency, I give permission for my child to be treated at any hospital and/or by any doctor or nominated first aider.

I understand that every effort will be made by the leaders to contact me in the event of any illness or accident.

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