Vancouver Island Youth Getaway
Lighthouse Youth | September 30-Oct 2
Important Information
Payment due upon registration. Please be advised that you will be responsible for your own ride to and from the Nanoose Bay Camp for the weekend. All registrations are due by Sept. 18
Name
First Name
Last Name
Age
Sex
Emergency Contact
Please enter a valid phone number.
BC Services Number
Dietary Restrictions
Medical Information
Payment ($80)
Etransfer to give@vilifechurch.com (in the message box put youth retreat)
Today's Date
-
Month
-
Day
Year
Date
Guardian Signature
Submit
Should be Empty: