Camp Wannastay 2024 Registration Form

Camper Information

Camper's Name*

First NameLast Name

Birth Date

MonthDayYear

Grade completed as of June 2025 (for JK in the fall put 01 / JK completed 02 / SK completed 03)*

MaleFemale

Camper's Shirt Size*

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Parent/Guardian Information

Name*

First NameLast Name

Home Number

Format: (000) 000-0000.

Cell Number*

Format: (000) 000-0000.

E-mail*

example@example.com

Emergency Information

Emergency Contact's Name*

First NameLast Name

Relationship*

Phone Number*

Format: (000) 000-0000.

Alt. Phone Number

Format: (000) 000-0000.

Does the camper have any allergies, chronic illness, or medical conditions? If yes, please describe. Please also list any medications the camper will be bringing with him/her. (If none, type none)*

Does the camper have any physical, emotional, mental, behavioural concerns or limitations that our staff should be aware of? If yes, please explain. (If none, type none)*

Informed Consent and Acknowledgement

I/we, the parents or guardians of the camper above, authorize Pastor Tracy Phelps or one of the Pastoral Church Ministry Staff to sign a consent form for medical treatment and to authorize any physician or hospital to provide medical assessment, treatment or procedures for the camper named above.

I/we named above, undertake and agree to indemnify and hold blameless Pastor Tracy Phelps, the Ministry Staff, of PDAC, its Pastors and Board of Elders from and against any loss, damage or injury suffered by the camper as a result of being part of the activities of the PDAC, as well as of any medical treatment authorized by the supervising individuals representing the church. This consent and authoerization is effective only when participating in or traveling to events of the PDAC.

I have read and agree to the above statements.*

Brochures / Promotional MaterialWebsiteChurch serviceNewsletters

Cash / Cheque dropped off to Paramount Drive Alliance Church on or before July 28, 2025e-transfer to payment@pdac-cma.com (What's it for? Camp2025)

Camp Wannastay 2025 Registration Form

July 28 - Aug 1, 9 am - Noon