HE HA HO

Youth Camp: August 19, 20 and 21
HE HO HA Camp
Cost: $350 per person (Food, accommodation, transportation and activities are included) for both gender age 12 and up
Youth
First
Last
Last
Birth date

MonthDayYear
Date
Age
Street Address
Town/City
postal code
Child’s Home Phone
Format: (000) 000-0000.
Parent/Guardian - Contact Information Parent/Guardian
First
Mrs. Mr. Ms.
Mrs. Mr. Ms.
Street Address
Town/City
Pro _ Zip Code
Home Phone
Format: (000) 000-0000.
Work Phone
Format: (000) 000-0000.
Cell phone
Format: (000) 000-0000.
E-mail
example@example.com
Emergency Contact Information – Alternate Pickup/Release Emergency Contact
First Name
Home Phone
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Work Phone
Format: (000) 000-0000.
Cell Phone
Format: (000) 000-0000.
Email
example@example.com
Relation to child
Medical Release Information
Health care
Please list any medical problems, including any requiring maintenance medication (i.e. Diabetic, Asthma, Seizures
Parent’s/Guardian’s Initials
I hereby give permission for the transportation of my child for AIYC/ Assiddiq camp activities by modes of transportation agreed to by the AIYC/ Assiddiq camp organizer.

. All scheduled events are subject to change. The AIYC/ Assiddiq organization is not responsible for lost or damaged personal property I understand that my child will participate in all AIYC/ Assiddiq camp activities and AIYC/ Assiddiq camp is not responsible for any damage during these activities
Guardian Signature
Date

MonthDayYear
Date
Printed Name of Parent/Guardian
Cost: $150 per person (Food, accommodation, transportation and activities are included)

Fee : $150 for first child , 120 for second and $100 for third child

Time of departure: July 26 at (Maharaja Banquet hall 92 57 – 34 a Ave @1:00 PM)

Camp location: Wide water – Slave lake 2:30 hours far from Edmonton

Indoor Accommodation is provided for girls and outdoor accommodation is provided to boys with tents

you need to bring sleeping bag or Blanket, pillow with sheets.( tent if you have one) . Also toiletry

When we return: July 28 at 5:00 PM In Sha Allah

Transportation: By school bus Food: provided Halal (3 meals) Activities: Canoeing, powerboat, swimming, hiking, sports and many more

For further info, call: Alami @ 780 885 6238 Email: Abdulalami@gmail.com Etransfer: AIYCedmonton@gmail.com
Should be Empty:

Youth Camp: August 19, 20 and 21

HE HO HA Camp

Youth

Medical Release Information