Vacation Bible Camp Registration

Camp Registration Form

Please fill out the form to register your child(ren) for our PA Day Camp on June 28th from 9-3:30 and/or Vacation Bible Camp on July 29-Aug 2. You will receive a confirmation email within 3 business days if your child obtains a space in our program.
Parent/ Guardian Name *

First Name Last Name
Additional Parent/ Guardian Name

First Name Last Name

Address *

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

E-mail contact *
example@example.com
Phone Number *

Area Code Phone Number
Work Number

Area Code Phone Number
Emergency Contact *

First Name Last Name Relation to Child
Emergency contact Phone Number *

Area Code Phone Number
Who may pick up your child? *

Mom Dad Emergency Contact
Do you attend a church? If so, where? *
I give Westview permission to use photos of my child(ren) for church slideshows, newsletter, website, crafts and promotional material. *

Yes, I give full photo permission Yes, but no online photos Photos for kids personal crafts only please No photos please
My Child(ren) will attend

Full Day Camp - July 29- Aug 2 from 9-4pm; $80 per child (T-shirt included) Morning Only - July 29- Aug 2 from 9-12 noon June 28th PA Day - 9-3:30 ($15) This is a splash pad trip day, weather permitting.
All Campers: Precautions are taken for the safety and health of your child(ren), but in the event of accident or sickness, Westview Baptist Church, it's staff, and volunteers are hereby released from any liability. In the event that your child requires special medication, x-rays, or treatment, the parents/ guardians will be notified immediately.

Notice for Full Day Program Only: I give permission for my child to walk to, or take a bus to trips throughout the week including the Palasad, the Jesse Davidson Splash Pad and another trip TBD. Trip details will be confirmed closer to camp. Trips are also subject to change depending on weather and unforeseen circumstances.

Payment of $80 (cash or cheque) per child should be delivered or mailed to Westview Baptist Church within 1 week of registration;

1000 Wonderland Rd S; London, ON; N6K3S4.

If payment is not received within 1 week, I understand that my child's space may be given to a child on a waiting list. If I withdraw my child from this program after June 28th, I understand that a $25 administration fee will be retained.
I have read and agree to the above statements *

Yes
First Child's Name *

First Name Last Name
Birth Date *

Month Day Year
Gender
Health Card #
Grade Finished
T-Shirt Size *

My child is in the Morning Program only and I do not need a T-shirt Small Medium Large XLarge My Child has a shirt from last year that will be worn, please add a $5 discount to the registration
Allergies or Medical Concerns
If your child needs medication for any condition (eg. EpiPen) written consent must be given to a specific person(s) before we can administer any medication.
Second Child's Name

First Name Last Name
Birth Date

Month Day Year
Gender
Health Card #
Grade Finished
T-Shirt Size

My child is in the Morning Program and I do not need a T-shirt Small Medium Large XLarge My Child has a shirt from last year that will be worn, please add a $5 discount to the registration
Allergies or Medical Concerns
If your child needs medication for any condition (eg. EpiPen) written consent must be given to a specific person(s) before we can administer any medication.
Third Child's Name

First Name Last Name
Birth Date

Month Day Year
Gender
Health Card #
Grade Finished
T-Shirt Size

My child is in the Morning Program only and does not need a T-shirt Small Medium Large XLarge My Child has a shirt from last year that will be worn, please add a $5 discount to the registration
Allergies or Medical Concerns
If your child needs medication for any condition (eg. EpiPen) written consent must be given to a specific person(s) before we can administer any medication.
Additional Comments or Questions
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Camp Registration Form