Camp registration 1Parent/guardian contact2Camper info3Authorization Number of campersHow many children are you registering for camp?*1 camper2 campers3 campers4 campers(You will be asked to fill out info for each camper starting on the next page.)Parent/guardian informationMain parent contact* Mr.Mrs.MissMs.Dr.Prof.Rev. Prefix First Last Main contact email* Main contact phone*Main contact address* Street Address City AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Province Postal Code Emergency contactRelationship to camper(s)* Emergency contact name* Mr.Mrs.MissMs.Dr.Prof.Rev. Prefix First Last Emergency contact - primary phone*Emergency contact - secondary phoneName of any other adults authorized to pick up your child(ren) from camp Camper 1 informationCamper's name* First Middle Last Camper's date of birth* Month Day Year Camper's gender* male female Camper's grade September 2019* Camper's t-shirt size*Youth smallYouth mediumYouth largeYouth x-largeHealthcard #* Allergies: list any allergies that we should be aware ofBehaviour issues: To help ensure the best possible camp experience for your son or daughter (and other campers) please list any behavior issues we should be made aware ofSpecial Considerations and Requests: If you have any special requests or considerations that your child will need please let us know in the field belowPlease be advised that while we will work hard to help accommodate for these needs we cannot guarantee that all requests will be fulfilled.Camper 2 informationCamper's name* First Middle Last Camper's date of birth* Month Day Year Camper's gender* male female Camper's grade September 2019* Camper's t-shirt size*Youth smallYouth mediumYouth largeYouth x-largeHealthcard #* Allergies: list any allergies that we should be aware ofBehaviour issues: To help ensure the best possible camp experience for your son or daughter (and other campers) please list any behavior issues we should be made aware ofSpecial Considerations and Requests: If you have any special requests or considerations that your child will need please let us know in the field belowPlease be advised that while we will work hard to help accommodate for these needs we cannot guarantee that all requests will be fulfilled.Camper 3 informationCamper's name* First Middle Last Camper's date of birth* Month Day Year Camper's gender* male female Camper's grade September 2019* Camper's t-shirt size*Youth smallYouth mediumYouth largeYouth x-largeHealthcard #* Allergies: list any allergies that we should be aware ofBehaviour issues: To help ensure the best possible camp experience for your son or daughter (and other campers) please list any behavior issues we should be made aware ofSpecial Considerations and Requests: If you have any special requests or considerations that your child will need please let us know in the field belowCamper 4 informationCamper's name* First Middle Last Camper's date of birth* Month Day Year Camper's gender* male female Camper's grade September 2019* Camper's t-shirt size*Youth smallYouth mediumYouth largeYouth x-largeHealthcard #* Allergies: list any allergies that we should be aware ofPlease be advised that while we will work hard to help accommodate for these needs we cannot guarantee that all requests will be fulfilled.Behaviour issues: To help ensure the best possible camp experience for your son or daughter (and other campers) please list any behavior issues we should be made aware ofSpecial Considerations and Requests: If you have any special requests or considerations that your child will need please let us know in the field belowPlease be advised that while we will work hard to help accommodate for these needs we cannot guarantee that all requests will be fulfilled. AuthorizationBy clicking the “I agree” button, I acknowledge and agree to the following: 1. I am the parent or legal guardian of the participant 2. I release all individuals and groups associated with Lampstand Christian Church from liability associated with any accident or sickness experienced by the applicant with the understanding that the camp staff will be taking reasonable precautions to guard against any situation of this nature. 3. I give permission to the reasonable use of photos, which may be used on our social media site 4. The participant’s immunizations are up to date and I believe the participant to be in good health. Any exceptions to this I have noted above. If I cannot be reached, I hereby authorize the camp staff to secure such medical advice and services as may be deemed necessary for the health and safety of the participant. 5. I understand that weather permitting; participants will be safely escorted down the street to the park during the group activities to play sports.Check the box below to submit this registration form* I AGREE I would like to informed of all upcoming events at Lampstand I would like to be made aware of other camps and kids activities held at Lampstand
