TEENS CAMP 2026 Registration Form

TEENS CAMP 2026 Registration Form
Age: Grades 7 - 12 (completed in 2026)

When: Friday, June 26 - Monday, June 29

Where: Capernwray Harbour Bible Centre, Thetis Island

Registration Fee:

Early-bird (May 1 - May 15): $420

Regular (May 16 - May 31): $440

Registration Deadline: Sunday, May 31, 2026

Payment Options: Cash, Cheque, & E-Transfer (payments made to donations@fraserlands.ca - in the message box, please include "TC26 First & Last Name")

*Please note: Your payment must be received in order for your child's spot to be secured.

Caregiver Information
Primary Caregiver Name*

First NameLast Name
Relationship to Attendee*

MotherFatherLegal GuardianOther
Primary Caregiver Address*

Street Address

Street Address Line 2

CityProvince

Postal Code
Primary Caregiver Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Primary Caregiver Email*
example@example.com
Alternate Emergency Contact Name*

First NameLast Name
Emergency Contact Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.

Health & Medical Information
Personal Health Number (PHN)*
Found on the back of your BC Services Card or Driver's License
Family Doctor's Name
Family Doctor's Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Important Medical Conditions*
Enter N/A if the attendee has no medical conditions to report
Food Allergies or Dietary Restrictions*
Enter N/A if the attendee has no food allergies or dietary restrictions to report
Current Medications*
Enter N/A if the attendee has no current medications to report

Fraser Lands Church Consent & Liability Release Statements
FRASER LANDS CHURCH CONSENT FOR MEDIA RELEASE: I, the undersigned, give permission to FRASER LANDS CHURCH and/or parties designated by FRASER LANDS CHURCH to photograph/video my child and use such photograph(s)/video(s) in all forms of media, for any and all promotional purposes including advertising, display, audiovisual, exhibition or editorial use. I understand and agree that I or my child will not receive any payment or expenses or any royalty for the publication of the photograph(s)/video(s) and I hereby release FRASER LANDS CHURCH and/or any parties designated by FRASER LANDS CHURCH from any such claims. I certify that I have read and fully understand this consent and release, and that all questions pertaining to this consent have been answered to my satisfaction.

I Agree
FRASER LANDS CHURCH CAREGIVER CONSENT FOR MEDICAL TREATMENT AND COMPLETE RELEASE, WAVIER OF CLAIM, ASSUMPTION OF RISK, AND INDEMNITY. THIS IS A LEGAL AGREEMENT. BY SIGNING THIS AGREEMENT, YOU INDICATE THAT YOU UNDERSTAND THE RISKS ASSOCIATED WITH PARTICIPATING IN SERVICES AND GIVE UP CERTAIN RIGHTS, INCLUDING THE RIGHT TO SUE. PLEASE READ CAREFULLY: I/we, the legal caregivers named above, authorize FRASER LANDS CHURCH, and/or parties designated by FRASER LANDS CHURCH, to sign a consent for medical treatment and to authorize any physician or hospital to provide medical assessment, treatment or procedures for the participant named above. I/we, the legal caregivers named above undertake and agree to indemnify and hold blameless FRASER LANDS CHURCH, it’s pastors and Board of Elders, and/or parties designated by FRASER LANDS CHURCH from any loss, damage, or injury suffered by the participant as a result of being a part of the activities of FRASER LANDS CHURCH, as well as any medical treatment authorized by the supervising individuals representing FRASER LANDS CHURCH. This consent and authorization is effective only when participating in and travelling to and from the events of FRASER LANDS CHURCH.*

I Agree
Caregiver Signature (for Fraser Lands Church Consent & Release)*

Capernwray Harbour Bible Centre Consent & Liability Release Statements
CAPERNWRAY HARBOUR BIBLE CENTRE CONSENT FOR MEDICAL TREATMENT: In the event that specific medical treatment or procedure is deemed necessary, or advisable, during the diagnosis and treatment of myself (or, the child under my guardianship) as the participant so named above, by my signature below, I authorize any physician, or professionally trained medical support person, to perform this treatment or procedure. This authorization also covers surgical treatment by a physician, if deemed necessary.*

I Agree
CAPERNWRAY HARBOUR BIBLE CENTRE COMPLETE RELEASE, WAVIER OF CLAIM, ASSUMPTION OF RISK, AND INDEMNITY. THIS IS A LEGAL AGREEMENT. BY SIGNING THIS AGREEMENT, YOU INDICATE THAT YOU UNDERSTAND THE RISKS ASSOCIATED WITH PARTICIPATING IN SERVICES AND GIVE UP CERTAIN RIGHTS, INCLUDING THE RIGHT TO SUE. PLEASE READ CAREFULLY. IN CONSIDERATION of Torchbearers Capernwray Canada Society (the “Society”) permitting me to use the Society’s property, facilities, amenities (such as low element and team initiative courses, docks, climbing tower and pole, and nature trails) and equipment (together the “Facilities”), including the waterfront and dock adjacent to the Facilities (the “Waterfront”), located on Thetis Island, British Columbia, and to partake in activities sponsored or organized by the Society (the “Activities”), I, THE UNDERSIGNED, AGREE TO THE FOLLOWING TERMS: I, the undersigned, release the Society and its employees, representatives, volunteers, directors and officers (collectively called “Capernwray”) from all liability and waive as against Capernwray all recourse, loss or damage, including any consequential loss or damage, claims, causes of action of any kind whatsoever for any personal injury, death, property damage or loss that I may suffer or that my next of kin may suffer as a result of my participation in the Activities carried out on and in the vicinity of the Facilities or the Waterfront, howsoever caused, including if contributed to or occasioned by the negligence of Capernwray. I voluntarily accept the physical risk together with the legal risk, thereby expressly giving up any right of legal action. I further acknowledge and agree: a) To follow the rules and regulations established by Capernwray. b) That the Facilities and Waterfront are in a natural setting which presents changes and variability in the terrain and weather as well as other unpredictable elements. As such the Facilities, Waterfront and Activities may present certain risks, hazards and dangers to my person and my property, including, but not limited to: injuries resulting from slips and falls; injuries resulting from exposure to cold, wet or windy weather, or the effects of heat and sunlight; and injuries resulting from use, misuse, non-use or failure of equipment. c) That waterfront supervision provided by the Society are on duty at the Waterfront only during designated hours and that I assume a greater degree of risk by using the Waterfront outside of the designated hours. d) That one of the risks inherent in group activities is the possible transmission of viruses, bacteria and other pathogens, including the virus which causes ‘COVID-19’, and that exposure to or infection with viruses, bacteria or other pathogens may lead to quarantine requirements, illness, disability or death, despite Capernwray’s reasonable efforts to comply with the British Columbia Centre for Disease Control’s and Ministry of Health’s requirements for group activities. e) That some of the aforesaid risks, hazards and dangers are foreseeable but others are not. f) That I nevertheless freely and voluntarily assume all the aforesaid risks, hazards and dangers, and the possibility of personal injury, death, property damage or loss resulting from the risks, hazards and dangers, and that, accordingly, my use of Facilities and Waterfront while participating in any Activities is entirely at my own risk. g) To indemnify and save harmless Capernwray from and against all liability, claims, causes of action, loss or damage, including any consequential damage or loss, demands, costs and expenses of any kind whatsoever that Capernwray may suffer as a result of any personal injury, death, property damage or loss arising out of my participation in the Activities carried out on and in the vicinity of the Facilities or Waterfront, howsoever caused, and notwithstanding that such personal injury, death, property damage or loss may have been contributed to or occasioned by the negligence of Capernwray. h) That I have carefully read this COMPLETE RELEASE, WAIVER OF CLAIM, AND ASSUMPTION OF RISK, that I fully understand same and its legal effect and that I am freely and voluntarily executing the same. i) That I understand that Capernwray does not and will not permit me to participate in any program I register for unless I sign this COMPLETE RELEASE, WAIVER OF CLAIM, AND ASSUMPTION OF RISK, which applies to all of the Activities, and that the terms of this Agreement need not be brought to my attention each time I am participating in Activities in order to be effective. j) That if any of the terms of this COMPLETE RELEASE, WAIVER OF CLAIM, AND ASSUMPTION OF RISK or their application to any party or circumstance is held invalid by any court or other authority having jurisdiction, the remainder of this COMPLETE RELEASE, WAIVER OF CLAIM, AND ASSUMPTION OF RISK and the application to parties or circumstances other than those as to which it is held invalid will not be affected. k) That I give Capernwray the right to use, and consent to the use of, photographs and videos of me involved in Activities for Capernwray’s promotional purposes. l) That I verify that I am 19 years of age or older, (Parent or legal guardian must sign for minor). I have read and understand all of the authorizations and conditions on this registration and waiver form under the headings “Consent to Treatment” and “Complete Release, Waiver of Claim, Assumption of Risk, and Indemnity”, and I agree to be bound by them. I acknowledge and agree that they are binding on my heirs, executors, my administrators, personal representatives, assigns, and myself:*

I Agree
Caregiver Signature (for Capernwray Harbour Bible Centre Consent & Release)*
Should be Empty:

TEENS CAMP 2026 Registration Form

Attendee Information

Caregiver Information

Health & Medical Information

Fraser Lands Church Consent & Liability Release Statements

Capernwray Harbour Bible Centre Consent & Liability Release Statements