Ecumenical Day Camp Registration

Ecumenical Day Camp Registration
Amazing Journey Day Camp: A seaside adventure in Ancient Greece

July 8-12, 2019; Mornings 9 AM - 12 Noon @ St. George's Cadboro Bay Anglican Church, 3909 St. George's Lane, Victoria
Early Bird Registration (Deadline June 7, 2019)

$25 first child, $20 second child, $15 third child & additional children

After June 7th, 2019

$35 first child, $30 second child, $25 third child & additional children

Children with special needs may attend with an assistant.

If transportation is an issue please contact us at amazing4kids@gmail.com

Payment can be made either via e-transfer to lutheranchurchofthecross@shaw.ca

or cheque may be made payable to Lutheran Church of the Cross with "Amazing Journey" written in the memo line.

You may drop off or mail payment to any of the three participating churches:

St. George's Cadboro Bay Anglican Church: 3909 St George's Lane, Victoria, BC, V8N 4E3

St. Luke's Cedar Hill Anglican Church: 3821 Cedar Hill Cross Road, Victoria, BC, V8P 2M6

Lutheran Church of the Cross: 3787 Cedar Hill Road, Victoria, BC, V8P 3Z4
Child Name

First NameLast Name
Date of Birth (YY/MM/DD), Grade Completed, BC Care Card#, Allergies
Additional Child (if applicable)

First NameLast Name
Date of Birth (YY/MM/DD), Grade Completed, BC Care Card#, Allergies
Additional Child (if applicable)

First NameLast Name
Date of Birth (YY/MM/DD), Grade Completed, BC Care Card#, Allergies
Additional Child (if applicable)

First NameLast Name
Date of Birth (YY/MM/DD), Grade Completed, BC Care Card#, Allergies
Parent/Guardian Name

First NameLast Name
Parent/Guardian E-mail Address
Parent/Guardian Name (if applicable)

First NameLast Name
Parent/Guardian E-mail Address
Home Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Primary Phone Number

Area CodePhone Number
Alternate Phone Number (if applicable)

Area CodePhone Number
Emergency Contact

First NameLast Name
Emergency Contact Relationship
Emergency Contact Phone Number

Area CodePhone Number
Note: Children will only be released to those listed on this form.
Person Picking up child(ren)

First NameLast Name
Area CodePhone Number
Alternate Person Picking up child(ren) (if applicable)

First NameLast Name
Area CodePhone Number
How did you hear about this program?
Photograph/Video permission: We intend to take photos and video recordings during this event to used on social media, newsletters, and future promotion.

I GIVE permission for my child(ren) to be phographed/video recorded.I DO NOT GIVE permission for my child(ren) to be phographed/video recorded.
In the event that your child requires medical attention, they will be transported to the nearest emergency centre including by ambulance if necessary, and you will be responsible for any associated costs.
Signature of Parent or Guardian

Clear
Today's Date (YY/MM/DD)
Thank you for enrolling your child in Summer Camp.

We look forward to the Amazing Journey that awaits this summer.
Should be Empty:

Ecumenical Day Camp Registration

Amazing Journey Day Camp: A seaside adventure in Ancient Greece