2026 Summer Getaway

Registration Information
Your Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Contact Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Contact Email*
example@example.com
Registration type*
Gender*
Age group*
Preferred roommate, if any
We cannot guarantee placement
Please list any allergies or health concerns.
Emergency contact #1: *

First NameLast Name
Emergency contact #1*
Please enter a valid phone number.Format: (000) 000-0000.
Emergency contact #2*

First NameLast Name
Emergency contact #2*
Please enter a valid phone number.Format: (000) 000-0000.
I will be drivingI will be driving and can provide ridesI need transportationI am already carpooling
How did you hear about Summer Getaway?*
Participant Information

If you need to register 6+ participants, please submit a separate registration form.
Name #2

First NameLast Name
Registration type #2
Gender #2
Age group #2
Preferred roommate, if any
We cannot guarantee placement
Please list any allergies or health concerns.
Name #3

First NameLast Name
Registration type #3
Gender #3
Age group #3
Preferred roommate, if any
We cannot guarantee placement
Please list any allergies or health concerns.
Name #4

First NameLast Name
Registration type #4
Gender #4
Age group #4
Preferred roommate, if any
We cannot guarantee placement
Please list any allergies or health concerns.
Name #5

First NameLast Name
Registration type #5
Gender #5
Age group #5
Preferred roommate, if any
We cannot guarantee placement
Please list any allergies or health concerns.
Name #6

First NameLast Name
Registration type #6
Gender #6
Age group #6
Preferred roommate, if any
We cannot guarantee placement
Please list any allergies or health concerns.
Waiver and Release

Please read carefully
THIS IS A LEGAL DOCUMENT. BY SIGNING THIS DOCUMENT, THE VENDOR (THE

“PARTICIPANT”) ARE GIVING UP CERTAIN LEGAL RIGHTS AND ASSUMING CERTAIN

OBLIGATIONS. NOTWITHSTANDING PRECAUTIONS TAKEN, ACCIDENTS OCCUR

AND THIS AGREEMENT MUST BE SIGNED IN ANTICIPATION OF THAT POSSIBILITY.

TO: HOME Church in Riley Park Vancouver BC (the “Church”) at 215 East 18th Avenue, Vancouver, BC.
In consideration of the Church sponsoring or being involved with various functions with the Participant from July 3, 2026 to July 5, 2026 (Summer Getaway) the undersigned Participant hereby:
1. understand that these functions may involve some risks;
2. understand that unintended injuries and death may possibly result as a consequence of participation in such functions;
3. accept full risk and responsibility for the death of or injury to the Participant or damage to the property of the Participant arising from the functions or transportation of the Participant at such functions;
4. waive any rights whatsoever that the undersigned and Participant may have now or in the future against the Church and, as applicable, its members, directors, officers, leaders, agents and employees as a result of death or injury to the Participant or damage to the property of the Participant arising from the participation in the functions;
5. release and forever discharge the Church and, its members, directors, officers, leaders, agents and employees from all actions, causes of action, suits, claims and demands whatsoever, that may rise from any functions however caused;
6. agree and understand that this document will be binding on the heirs, executors, administrators and assigns of the undersigned parents/guardians and the Participant;
7. indemnify and hold harmless the Church, its members, directors, officer, leaders, agents and employees from any actions, suits, claims, demands whatsoever, arising from any negligent, wrongful or illegal act or omission of the Participant in respect of any function or transportation sponsored, arranged or coordinated by the Church or its agents; and
8. agree that if any provision hereof is invalid, illegal or incapable of being enforced by reason of any rule of law or public policy then such provision will be served from and will not affect any other provision contained herein, and this instrument will be read as if such invalid, illegal or unenforceable provision had never been contained herein and all other provisions hereof will, nevertheless, remain in full force and effect and no provision will be deemed to be dependent upon any other provision.
9. Accept vendor responsibilities, liabilities, and purpose of the event ensuring products and services will be exchanged at the ownership and liability of the vendor at this function.
The undersigned acknowledges that they have read, understand, and agree to the foregoing.*
Printed Name*

First NameLast Name
Today's Date*

MonthDayYear
Date
CHILD(REN) (age 18 and under) attending the event with parent(s):
Child Name #1

First NameLast Name
Parent signature
Child Name #2

First NameLast Name
Parent signature
Child Name #3

First NameLast Name
Parent signature
Payment Method
cash (in person)cheque (in person)Interac e-transfercredit card (online, +$10 transaction fee per person)
I AGREE that my registration is not complete and confirmed until payment in full has been received. Once received, there is NO refunds, partial or full. You may transfer the registration to another person by notifying us at info@ourhomechurch.ca, leaving a voicemail at 604-876-1221, visiting us in person.

Summer Getaway Registration

Adult Registration (Ages 11+)

$250.00CAD Quantity

Student Registration (Ages 11+)

$210.00CAD Quantity

Child Registration (Ages 3-10)

$175.00CAD Quantity

Child (Under 3)

$ FreeCAD Quantity

Enter coupon

Total

$0.00CAD

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

Payment Details

For cash, cheques, and e-tranfers.
Please note that your registration is not complete or confirmed until we have received the payment in full.

For cash: Please bring the exact amount to the registration table in between our services in the foyer.

For cheques: Please make cheques payable to Home Church and bring it to the registration table in between our services in the foyer.

For Interac e-transfers: Please send payment to give@ourhomechurch.ca after submitting this form. Please indicate in the e-transfer message that the payment is for the Summer Getaway and your name on the registration form so that we can match the payment with the form.
Number of adult registrations ($240 by May 3, $285 from May 4 to June 15)
Number of student registrations ($200 by May 3, $245 from May 4 to June 15)
Number of child (ages 3-10) registrations ($165 by May 3, $200 from May 4 to June 15)
Number of child registrations under 3 years-old (Free)
Fee total:
Should be Empty:

Registration Information

Participant Information

Waiver and Release

Payment Method

Payment Details