Kootenay Covenant Bible Camp - Boys Registration

Kootenay Covenant Bible Camp - Waitlist Registration

To book for a place in the the camp, you must complete the form below accurately.
Campers Name*

First NameLast Name
Please provide any medical or dietary restrictions the camper has.*
Campers Gender

MaleFemale
Birth Date

MonthDayYear
Camper Heath Card Number*
A Cabin Mate Request*
Parent/Guardian's Name*

First NameLast Name
Phone Number*
Alternate Phone Number*
Email Address*
example@example.com
Church affiliation (if any):*
Primary Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Emergency Contact Information
Emergency Contact Name*

First NameLast Name
Contact Phone Number*
E-mail Address*
example@example.com
Relationship to Camper*
Camper to be released to:*

Will you be sending multiple campers?*

YesNo
All campers this year will be provided with a T-shirt. What size shirt for this camper?*

SmallMediumLargeExtra-large
- Non-swimmer or Beginner
  (A non-swimmer, may demonstrate paddling and kicking coordination but uses assistance when swimming, may demonstrate a fear of the water)
- Intermediate
  (Demonstrates forward motion in the water on back and front without assistance, endurance and technique need improvement)
- Advanced
  (Able to swim the length of the pool without stopping, demonstrates proficient front and back stroke skills, interested in learning additional strokes)
Campers Swim Level *

Parental Agreements
Parental/Legal Guardian Consent and Medical Release: My agreeing to this form indicates the above named person has permission to engage in all camp activities, on and off camp grounds, to be transported, and to participate in outings and field trips off Kootenay Covenant Bible Camp (KCBC) grounds, except as noted. (This completed form may be photocopied for trips out of camp.) I support the camp administration in enforcing camp rules and accept responsibility for payment of property damaged by my child. I understand that my child could be sent home if she/he becomes a hazard to the safety and the rights of others, has appeared to have rejected the reasonable controls of camp, or has been found with a prohibited substance. I will speak directly to the Camp Director before removing my child, at anytime, from the camp grounds. I authorize the dispensing of medications that accompany my child and the dispensing of common over-the counter medications that might be needed. I give the camp personnel the authority to act on my behalf in case of an emergency, including medical treatment. (Parent/Guardian will be notified as soon as possible). I understand that I am financial responsible for costs incurred. I agree to the release of any records necessary for insurance purposes. I hereby release KCBC and its personnel from all claims for damages arising from any accident or injury caused by my child’s participation in the camp program. I give permission for my child’s picture to be used in KCBC publications and promotions and the use of the email address to be used only for KCBC communication to you the parent or Guardian.
Do you Agree with the above statement?*

Yes, I agree to the Policies and Procedures

The agreement below must be signed by each individual camper and by his/her parents or legal guardian. Our Promise To You The Director and Leaders of Kootenay Covenant Bible Camp promise to provide a safe place for the growth of the whole person. Our effort will be to generate a physical, social and spiritual atmosphere that is nurturing, creative, and joyful. Our focus will be to stimulate an environment in which the Holy Spirit can work. Your Commitment To Us I recognize that KCBC is a Christian camp and that my behaviour, language, dress and attitudes will be encouraged in the direction of developing a Christ-like character. As a camper, I promise to treat the camp leaders and staff with respect and to abide by their decisions and guidelines for the week. I will obey all camp curfews and will not leave the grounds or enter the lake without permission. I understand that the use of tobacco, alcohol, and illegal drugs are not permitted at camp and that all prescription drugs must be handed in to the camp First-Aid person. I also will not bring prohibited items to camp. Where possible I promise to participate in all scheduled camp activities and cooperate with energy and enthusiasm. I promise to respect and enjoy my fellow campers and avoid hurting them physically or by verbal ridicule. I understand that failure to keep the above promise could mean that I will be sent home early, forfeiting all of the camp fees that have been paid. My signature indicates that I understand and accept the above agreement and will conduct my behaviour according to the terms of this agreement.
Camper Agrees to the Terms.*

Yes, I understand my role as a camper
Should be Empty:

Kootenay Covenant Bible Camp - Waitlist Registration

Emergency Contact Information

Parental Agreements