TVBC Teen Camp Registration 2019
Email address *
I would like to register my camper for: *
Required
Camper's First & Last Name *
Your answer
Male or Female *
Camper's Date of Birth *
MM
/
DD
/
YYYY
Camper's Age *
Required
Street Address, City, Province, Postal Code *
Your answer
Home Phone *
Your answer
Work/Cell Phone (Parent/Guardian) *
Your answer
Emergency Contact's Name and Relationship to Camper *
In the event of an emergency we will contact the parent/guardian first using the phone numbers submitted above. If we are unable to make contact with the parent/guardian at the phone numbers listed above we will then use the emergency contact listed.
Your answer
Emergency Contact's Phone *
Your answer
Camper's Med. # and Exp. Date (If from U.S. state health insurance provider) *
Your answer
Please List Known Allergies *
If there are no known allergies please respond with "N/A"
Your answer
Please list medications and dosages. (Medications must be turned in to registrar upon arrival in their original container with clear written instructions.) *
If there are no medications please respond with "N/A"
Your answer
Please indicate if your child has a history of any of the following: *
Required
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