Closed for this Camp Season - LFBC Camper Registration

Closed for this Camp Season - LFBC Camper Registration - 2025
Parent or Guardian's Name*

First NameLast Name
Primary Phone #*

Area CodePhone Number
Secondary Phone #

Area CodePhone Number
Parent's Email*
example@example.com
Submitting this form on behalf of...
Camper's Name*

First NameLast Name
MaleFemale
Camper's Birthday*

MonthDayYear
Date
What grade will the student be completing this year?
Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Basic Health
Family Doctor

First NameLast Name
Family Doctor Phone Number

Area CodePhone Number
Family Health #*
Campers Personal Health #*
Emergency Contact

(Someone other than the parent/guardian completing this registration. In an emergency we will contact you first; this is just in case we can't get through to you.)
Name*

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Primary Phone Number*

Area CodePhone Number
Secondary Phone Number

Area CodePhone Number
Third Phone Number

Area CodePhone Number
Relationship to Camper*
Other Health
Current Medications:
Allergies:
Asthma:
Dietary Restrictions:
Does your child have any behavioral or physical challenges that may require additional staff support? If yes, please explain:
REGISTRATION
Kids Week - completing Gr. 2-5 this year (July 28-August 1)Teens Week - completing Gr. 6-9 this year (August 3-8)
Are there any other campers you are hoping will be in your child's cabin?
Important note: we cannot guarantee that all requests are accommodated.
Youth SmallYouth MediumYouth LargeYouth X-LargeAdult SmallAdult MediumAdult LargeAdult X-Large
Camp Information
TRANSPORTATION:

Kids Week
- Option 1: Bus will leave RFC at 8:30AM on Monday, July 28th and return to the church on Friday, August 1st at 5:30PM
- Option 2: You may choose to drop off your camper at camp on July 28th at 11:30am and/or pickup your child at camp on August 1st at 2:30pm.
Teens Week
- Option 1: Bus will leave RFC at 2PM on Sunday, August 3rd and return to the church on Friday, August 8th at 5:30PM
- Option 2: You may choose to drop off your child at camp on Aug 3rd at 5pm and/or pickup your camper at camp on August 8th at 2:30pm.
Camper will take bus both ways (to and from camp)Camper will only take bus to camp, but be picked up at camp at the end of week (2:30pm)Camper will be dropped off at camp (11:30AM), but take bus homeCamper will NOT take the bus (drop off at 11:30AM on the 1st day, Pickup at 2:30PM on Friday)We are currently undecided about camper transportation. We will take responsibility to update the camp registrar by email ASAP (take note: the option for bus transportation is not guaranteed after July 7th)
COST:

Kids Week: $210/camper
Teens Week: $240/camper
E-TransferChequeCampership Program
Online Form (Note that $7.50 is added to cover Credit Card Fees)E-TransferChequeCampership Program
If you have questions about how to pay, please contact the camp before sending in the application (lfbcmail@gmail.com).
Please note that your child will only be accepted into camp once full payment is received. You can expect to receive an e-mail confirming acceptance once payment has been processed

Credit Card Payment Info (For families with multiple children attending camp and are paying by credit card, please pay for each camper separately to avoid confusion on our end.)

Kids Week (August 8-12)

Finished Gr. 2-5

$217.50CAD

Teens Week (August 14-19)

Finished Gr. 6-9

$247.50CAD

Transportation (Bus)

Fee covers both directions. No reduced fee for only one way.

$30.00CAD

Total

$0.00CAD

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Other Payment Details
Send E-transfer to: lfbcmail@gmail.com (To avoid confusion on our end, please write the names of the campers you are paying for in the memo line.)

Mail cheques to: (To avoid confusion on our end, please write the names of the campers you are paying for in the memo line.)

LFBC
Box 188
Rosenort, MB
R0G 1W0

LFBC Campership Program:

The LFBC Campership Program is available to families who would benefit from financial assistance to help cover the cost of camp for their children. If you would like to apply for this program, please select "campership program" from the payment option above and briefly explain your reason for applying to the campership program below:
BY SUBMITTING THIS FORM, YOU AGREE TO THE FOLLOWING:

Every precaution is taken for the safety and good health of our campers. The acceptance by the LFBC camp director of this application, and the submission of this form, shall give the camp director and/or staff the right to arrange for special services or other requirements necessary in the best interest of the applicant and shall give the camp director the right to obtain or approve any medical attention necessary to the applicant camper's welfare and good health and the parent hereby agrees to pay for all services as may be required as indicated above. LFBC, its directors, staff members, and employees are hereby released from any and all liability in the event of any accident or misfortune that may occur to the applicant camper. Pictures may be used for promotional purposes.
Should be Empty:

Closed for this Camp Season - LFBC Camper Registration - 2025

Basic Health

Emergency Contact

Other Health

REGISTRATION

Camp Information

Other Payment Details