Youth Day Camp
August 5-8, 2025
Participant's Name
*
First Name
Last Name
Parent/Guardian Name
*
First Name
Last Name
Parent Guardian Email
*
example@example.com
Parent/Guardian Phone Number
*
Please enter a valid phone number.
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Date of birth
*
-
Month
-
Day
Year
Date
What grade is the participant going into in the fall?
*
Gender
*
T-shirt Size
*
Please Select
Youth Small
Youth Medium
Youth Large
Youth X-Large
Adult Small
Adult Medium
Adult Large
Adult X-Large
Adult XX-Large
Adult XXX-Large
How did you hear about our camp?
*
Please Select
I’ve attended before!
Poster at church/school
Invited by a friend/family member
Heard about it by someone that has attended before
From my coach
Saw it on the LCBI website
Google Advertisement
Social Media
This is my first time at LCBI Summer Camp and I was invited by:
Emergency Contact
*
First Name
Last Name
Relationship to Emergency Contact
*
Emergency Contact Phone Number
*
Please enter a valid phone number.
CAMPER MEDICAL INFORMATION
Name on Health Card
*
Health Card Number
*
What medical conditions should we be aware of?
*
PAYMENT
Payment Option
*
Credit Card
E-Transfer to accountant@lcbi.sk.ca
Payment Selection
*
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Youth Camper
A credit card fee of 3% will be applied at checkout
$
100.00
CAD
Quantity
0
1
Item subtotal:
$
0.00
CAD
Credit Card
E-transfer reference number
WAIVERS
Cancellation & Refund Policy
A camper may cancel their registration, up to 14 days prior to the start of the camp they are registered for, and they will receive a refund of their registration fee, minus a $20 non-refundable deposit. Any cancellations less than 14 days prior to camp must be for documented medical reasons, in order to receive a refund of their camp fee, minus non-refundable deposit.
I hereby authorize the staff of LCBI High School to act for me according to their best judgement in any emergency requiring medical attention, and I hereby waive and release LCBI High School and Camp Staff of any and all liability for any injuries or illnesses incurred while at camp. I have no knowledge of any physical impairment that would be affected by the camper's participation in the camp program.
*
Yes
I agree to allow LCBI High School to take pictures / video of my child while they are attending summer camp. I understand that the pictures /video will be used for future brochures, print and web-related publicity for the school.
*
Yes
No
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