2021 Day Camp registration

2021 Day Camp Registration

If you are interested in registering for Day Camp please fill out the form below. In filling out the form you are reserving a spot on a particular day of camp or week depending on what you select. Due to social distancing and health regulation your son/daughter will have to bring their own bag lunch please.
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Camper Name *

First Name Last Name
Parent Name *

First Name Last Name
Camper Birthday *

Month Day Year
Date
Home Church (if applicable)
Camper Age *
Biological Sex *

Male Female
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Email *
example@example.com
Parent Phone Number *

Area Code Phone Number
Medical Conditions
Allergies
If applicable any drugs or medical related issues we should know
Emergency Contact Primary *

First Name Last Name
Phone Number *

Area Code Phone Number
Emergency Contact Secondary

First Name Last Name
Phone Number

Area Code Phone Number
Please check the following medications if you give permission for the camp to administer age-appropriate dosage of over-the-counter medications. *

Tylenol (acetaminophen) Advil (ibuprofen) None
Does your son/daughter have any friends coming the same day, who?
West Bank Bible Camp Informed Consent and Assumption of Risk

With regards to participation at West Bank Bible Camp (hereinafter called WBBC), I acknowledge, understand and agree:

1. Despite precautions taken by WBBC, personal injury or accident may occur through activity participation. These activities include, but are not limited to, paintball, canoeing, zipline, giant swing, climbing and religious instruction. Through my signature on this form, I assume risks related to the use of any and all spaces used by WBBC.

2. To release WBBC from responsibility, including all staff, volunteers, and agents, and the facilities used from any cause of action, claims, or demands, now or in the future that might come from participation in activities at any point or from physical risks associated.

3. I accept all risks related to the such activities including personal injury, both major and minor, including death, may occur on camp premises. I understand these risks and will hold not WBBC liable for any such injury.

4. Furthermore, I understand that noncompliance with camp rules and policies, may result in disciplinary actions. Damage to property and facilities due to noncompliance is not tolerated and dealt with on a case by case basis.

5. I also consent to the use of any photograph of this camper in future publications.

6. I understand that West Bank Bible Camp is following the appropriate regulations and standards in dealing with COVID-19. I undertand there is a possibilty that my son/daughter may contract COVID-19 through the programming at camp. I, as the legal parent/guardian, will do my best to ensure my son/daughter is in good health and has not been in contact with a known or presumed case of COVID-19 within the last 14 days when they attend day camp.
I have read this Informed Consent and Assumption of Risk fully and understand and agree with the responsibility. I am assuming the risk and I am signing it freely and voluntarily. If I am the parent or guardian with legal responsibility for this camper I am signing it freely and voluntarily. *

Clear
Name Signing Weaver *

First Name Last Name
Phone Number

Area Code Phone Number
What activities are you interested in seeing this summer? (Select all that apply) *

Archery Pelletry Climbing Wall Canoeing Creeks, Crickets & Crayfish Hiking & Outdoor Cooking Paintball Games and Sport Drama Creation & Crafts Balloons, Bubbles, and Bracelets Art Skill for Juniors & Teens Zip Line Giant Swing Laser Tag
Single Day Camps: These will be normal one-day camps running for only one day.

Week-Long Day Camps: These will be week-long day camps where you will come every day of the week and the activities will have a progression throughout the week. This will be similar to a normal pre-covid week of camp without the overnights.

At Camp Drop Off/Pickup: If you are dropping off and picking up your child from camp, drop off will be 8:45 am at camp and pickup will be 5:30 pm at camp.

Bus Drop off/Pickup: If your child will be taking the bus from Swift Current, drop off will be at Bridgeway Church at 7:45-8:15 am and pickup will be at 5:30 pm at the church.
Camp Dates (Age by Dec 31 2021) *
June 30
July 1st
July 2nd
July 5
July 12
July 13
July 14
July 15
July 16
July 19
July 26
July 27
July 28
July 29
July 30
Aug 2-6
Aug 9
Aug 10
Aug 11
Aug 16
Aug 23
Aug 24
Aug 25
Aug nine-thirteen
June 30 Bus Ride

Yes No (-$10)
July 1st Bus Ride

Yes No (-$10)
July 2nd Bus Ride

Yes No (-$10)
July 5-9 Bus Rides

Yes No (-$50)
July 12 Bus Ride

Yes No (-$10)
July 13 Bus Ride

Yes No (-$10)
July 14 Bus Ride

Yes No (-$10)
July 15 Bus Ride

Yes No (-$10)
July 16 Bus Ride

Yes No (-$10)
July 19-23 Bus Rides

Yes No (-$50)
July 26 Bus Ride

Yes No (-$10)
July 27 Bus Ride

Yes No (-$10)
July 28 Bus Ride

Yes No (-$10)
July 29 Bus Ride

Yes No (-$10)
July 30 Bus Ride

Yes No (-$10)
Aug 2-6 Bus Rides

Yes No (-$50)
Aug 9 Bus Ride

Yes No (-$10)
Aug 10 Bus Ride

Yes No (-$10)
Aug 11-13 Bus Rides

Yes No (-$30)
Aug 16-17 Bus Rides

Yes No (-$20)
Aug 23 Bus Rides

Yes No (-$10)
Aug 24 Bus Rides

Yes No (-$10)
Aug 25 Bus Rides

Yes No (-$10)
Aug 9-13 Bus Rides

Yes No (-$50)
Donation (optional) We strive to keep camp affordable and you can help contribute to that. Donation Receipt available for gifts over $10.

None $5 $10 $20 $50
Subtotal

West Bank Bible camp

CAD Description

Credit Card
First Name	Last Name
Credit Card Number	Security Code
Expiration Date	Postal Code

Total *
Our Health Request

Please ensure your son/daughter is in good health and has not been in contact with a known or presumed case of COVID-19 within the last 14 days when they attend day camp. If you child falls ill, we as the camp will give you a full refund for your Day Camp or if there is availability we will change your reservation to another date. Advance notice of cancellations is requested.
Should be Empty:

2021 Day Camp Registration

Our Health Request