EVANGEL CHURCH
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Day Camp Registration Form

Please complete the following form and then click "Submit" at the bottom of this page to register your child(ren) for "Treasure Island" Day Camp 2009.

First Name of Parent
Last Name
Street Address
City
Province
Postal Code
Telephone Number
Emergency Telephone Contact
Email Address

How did you hear about this Day Camp?

 Sign

 Friend

 Letter/Card

 Church

 Radio

 The "Key"

 Television

 Newspaper
Other
Home Church, if applicable

Campers
Name of 1st Child (first & last names)
Date of Birth (use format: 25-Jan-99)
School Grade Level child has completed
Junior or Senior Camper (select one)

Name of 2nd Child (first & last names)
Date of Birth (use format: 25-Jan-99)
School Grade Level child has completed
Junior or Senior Camper (select one)

Name of 3rd Child (first & last names)
Date of Birth (use format: 25-Jan-99)
School Grade Level child has completed
Junior or Senior Camper (select one)

After submitting this form, please send a cheque (payable to "Evangel Church") for the amount(s) you have indicated to:
Evangel Church, 1260 Balmoral Street, Thunder Bay, ON P7B 5Z5

PLEASE NOTE: Your child is not officially registered for Day Camp until your registration payment has been received. Please ensure that your cheque is mailed as soon as possible following submission of this form. A Waiver and Medical Release Form will have to be filled out and signed for registration to be completed. Thank you.

Also note that pictures/video may be taken at Day Camp for various promotional purposes. Your registration payment is verification of your permission for such material to be used.

  




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