Camper Registration

Campers Form

Camp Week

Camper's Name #

Camper's Preferred Name

Gender

Age

Birth Date

Camper’s Shirt Size

Address

City

Province

Postal

Camper's Phone Number

Emergency Contact Phone Number

Emergency Contact Phone Number 2

Heath Card Number

Conversion Code

When does it Expire

Parent/Legal Guardian Name

Relation

Phone Number

Home Church

Pastor's Name

Parent's Email

Campers Email

Date of Last Tetanus Booster

List All Medications Taken Regularly

Reasons for Redication

Allergies

List Specific Activities to be Restricted and Reason

Dietary Restrictions

Other

Dietary Restrictions

Method of Payment

Camper Release List anyone, including parents, to whom your camper can be released

Today Date