HEIDELBERG BIBLE FELLOWSHIP
Day Camp 2024
Registration Form
August 6-9, 2024
Child's Name
*
First Name
Last Name
Birth Date (must have been born in the year 2011 or later.)
*
Please select a month
January
February
March
April
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June
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September
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December
Month
Please select a day
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Day
Please select a year
2024
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Year
School Grade in September 2024
*
Gender
*
Male
Female
Address
*
Street Address
Street Address Line 2
City
Province
Postal Code
Parent/Guardian Information
Name
*
First Name
Last Name
Home Number
Cell Number
E-mail
*
example@example.com
Emergency Information
Emergency Contact's Name
*
First Name
Last Name
Relationship
*
Please Select
Mother
Father
Grandparent
Aunt
Uncle
Sibling
Babysitter/Nanny
Other
Phone Number
*
Alt. Phone Number
Does the child have any allergies, chronic illness, or medical conditions? If yes, please describe.
Is the child prescribed an inhaler? If yes, please explain any instructions.
Does your child have any allergies or fears around animals? (specifically things like lizards, cats, and farm animals).
Does your child have one or more friends they would like to be with them in the same small group? (Note: Groups are age segregated - ages 6-8 and 9 -12)
Enter first and last name(s)
Any other information about your child that we should be aware of?
If someone other than you will be picking up your child, please indicate that person's name here. By submitting this form, you hereby give us permission to release your child into their custody.
Submit Form
Heidelberg Bible Fellowship
2720 Kressler Road, Heidelberg ON N0B 2M1
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