CT Kids Sleepover Event
Please complete the form below to register your child for the 'In Your Dreams' Sleepover Event. Payment can be completed below by credit card or through e-transfer info@ctbrandon.com or in person at the church office. Contact Angela if financial assistance is needed.
Child's Information
Child's Name
*
First Name
Last Name
Sex
*
Male
Female
Birthday
*
-
Month
-
Day
Year
Date
Grade
*
Please Select
Kindergarten
Grade 1
Grade 2
Grade 3
Grade 4
Grade 5
School
*
Please Select
Betty Gibson
Christian Heritage
Earl Oxford
George Fitton
Green Acres
Harrison
JR Reid
King George
Kirkaldy
Linden Lanes
Maryland
Meadows
New Era
O'Kelly
Riverheights
St. Augustine
Valleyview
Waverly Park
La Source
Alexander
Forrest
Oak River
Rapid City
Rivers
Souris
Home School
Other
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Is your child planning to sleep over on Friday night (November 22)?
Yes - planning stay the entire night
Yes - may need to be picked up during the night
No - I will pick them up at 8:30pm on Friday and drop off at 8:30am for breakfast.
Parent/Guardian Information
Parent/Guardian Name
*
First Name
Last Name
Parent/Guardian Cell Phone #
*
Please enter a valid phone number.
Format: (000) 000-0000.
Parent/Guardian Email
*
example@example.com
Parent/Guardian Name
First Name
Last Name
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Parent/Guardian Email
example@example.com
Emergency Contact
In Case Of Emergency, Please Contact:
*
First Name
Last Name
Emergency Contact Number (if different than Parent/Guardian)
Please enter a valid phone number.
Format: (000) 000-0000.
Relationship to Child
*
Medical Information
Personal Health ID Number (9 Digit)
*
Provincial Registration Number (6 Digit)
*
Does your child have any allergies?
*
No
Yes
If yes, please explain.
Does your child have any physical, emotional, mental, behavioural concerns or limitations that their leader(s) should be aware of?
*
No
Yes
If yes, please explain.
Does your child take any regular medication that they will need to take during the sleepover event?
*
No
Yes
If yes, please provide details.
Permissions
I give permission for photographs and videos be taken of my child for promotional purposes by a CT staff member.
*
Yes - photos may be used for in-house and online promotion
Yes - photos may only be used only for in-house promotion
No - photos may not be used for in-house or online promotion
I give my permission for my child to attend Calvary Temple's sleepover event 'In Your Dreams' on Friday November 22 - Saturday November 23.
I am herby released from any liability. In the event that my child requires special medication, x-rays or treatment, the parent/ guardian will be notified immediately. In case of surgical emergency, I hereby give permission to the physician selected by Calvary Temple staff to hospitalize, secure proper treatment for and to order injection, anesthesia or surgery for my child as named above.
Printed Name
First Name
Last Name
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'In Your Dreams' Kids Sleepover Event
Event Fee
$
55.00
CAD
Credit Card
Submit
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