Teen Camp #2 (Boys) Grades 7-9 - Individual Registration

First Name *

Last Name *

Address *

Address 2

City *

Postal Code *

Province *

Age at Camp *

Email *

Phone *

Parent/Guardian Name *

Emergency Contact *

Emergency Phone *

Requested Cabin Buddy

Health Card Number *

Personal Medical Number *

Is your child on any medication? *

Type of Medication:

Does your child have any allergies or medical conditions? *

Type of Allergy or Medical Condition: *

In case of emergency *

In case of emergency, I understand every effort will be made to contact me. In the event that I cannot be reached in an emergency situation, I hereby give permission to licensed emergency and health care personnel to provide treatment, services and transport necessary to maintain the health of my child. In the event medication, medical advice, treatment and/or equipment are required, I agree to accept financial responsibility for fees in excess of provincial and or private medical insurance. I agree that the information on this form may be disclosed to such emergency and health care personnel. In the event of illness, accident, emergency, or any other circumstance requiring medical treatment, such treatment may be procured for the participant without legal or financial obligation to Silver Bay Bible Camp. All known health issues of my child have been stated to the camp. I will notify the camp if my child is exposed to any infectious diseases prior to arriving at camp.

Agree to allow photographs *

I agree to allow photographs or video of camp activities, which may include my child, to be used in any and all camp promotional material.

Terms of agreement *

I have read and understood the terms of this agreement and BY ALLOWING MY CHILD(REN) to participate in the camp, I am voluntarily agreeing to abide to these terms. I confirm that the participant [my child] is physically and mentally able to participate in all activities of the camp, unless specifically indicated otherwise in writing.

Right to request

Silver Bay Bible Camp reserves the right to request any participant to withdraw from their camp if the participant is not acting in an appropriate and responsible manner.

Right to cancel *

Silver Bay Bible Camp reserves the right to cancel any week of camp and give a 100% refund.

Agree to share

I agree to allow Silver Bay Bible Camp to share my name, address & phone number with personnel & churches affiliated with the camp.

Permission to connect

We count it a privilege that you are sending your son or daughter to spend the week with us at camp this summer. During a week of camp, we look forward to many great friendships being formed! We have an amazing summer missionary team, and they love to stay connected with their campers throughout the year to hear how they are doing and answer any questions they may have about the topics discussed during chapel session and cabin devotionals. As part of our child and youth protection policy we are committed to honouring you as a parent/guardian and to asking your permission before any contact occurs between campers and our missionaries (Facebook, Twitter, phone calls, etc.). Our missionaries would be honoured to be able to continue to stay involved in your child or youth’s life after camp. Please initial to indicate whether or not you give permission to our missionaries to stay in contact with your son or daughter. If you wish to discuss this further, please contact the camp director by phone or email (please see camp website for contact information). If you wish to withdraw your permission, please contact the camp office immediately to notify the camp director.

Head Lice Check *

I understand, that as a part of Silver Bay Bible Camps effort to prevent the spread of head lice, all participants will be required to have a head lice check performed by one of Silver Bay Bible Camps staff during registration.

IN CONSIDERATION *

IN CONSIDERATION of being permitted to participate in any way at Silver Bay Bible Camp (hereafter known as ministry point), I acknowledge, understand, and agree: 1. Participation in activities could result in possible personal injury. Despite precautions taken by the ministry point, accidents and injuries may occur. By signing this form, I assume all risks related to the use of any and all spaces used by the ministry point. 2. To release from responsibility, the ministry point, including all missionaries, full-time and part-time, paid or volunteer, and the facilities used from any cause of action, claims, or demands now, and in the future that might arise out of the participant’s participation in activities at the ministry point or from the physical risks associated with the activities. 3. I accept all risks relating to such activities including personal injury such as: cuts, sprains, scrapes, bruises, fractures, broken bones, concussions, death, or any personal property damage/loss, which may occur on the camp premises. I understand these risks and will not hold the ministry point liable for any such injury. 4. Furthermore, I agree to obey all ministry point rules and take full responsibility for my behaviour in addition to any damage I may cause to the facilities utilized by the ministry point.

I have read *

I have read this Informed Consent and Assumption of Risk Agreement, fully understand its terms and the risks I am assuming by signing it, and sign it freely and voluntarily.

Donation

Please note it costs us approximately $300 for each child to stay a week at camp. Any additional monies will be issued a Charitable Tax Receipt.

T-shirt ($25)

Hoodie ($45)

Waterbottle

Yes, I would like a watterbottle. ($18)

Tuck Money

Please note a $50 deposit is required on all camps to hold your spot. This deposit is included in the total Amount below and will be refunded to you on registration day.

Please note that we usually have a waiting list for our camps. If we don't receive your payment within 7 days, we will not be able to hold your spot.

Amount

$

Payment Method *

Cheque or ETransfer Credit Card

Credit Card Number*

Expiration Date*

/

Card (CVV) Code*

Card Holder Name*

Registration Opens On April 1st!

Individual Registration

PARENT/GUARDIAN PERMISSION FORM

Informed Consent and Assumption of Risk

Additional Options

Payment Information