REGISTRATION
Van Es Camp & Conference Centre
natural simplicity...
A - Summer Camp Registration
Sign up for:
COST
Date
July 24 - 27, 2011
July 3 - 8, 2011
July 17 - 23, 2011
July 10 - 16, 2011
July 28 - 31, 2011
$ 125
$ 200
$ 255
$ 255
$ 125
B - Camper Information
Phone:
Name:
Address:
City:
Province:
E-mail:
Church:
Cell:
Birthday:
Postal Code:
Child Size
or Adult Size
C - Parent or Guardian Information
Mother:
Father:
If either mother, father or alternative caregiver has a different address than camper, please indicate alternate contact information below:
Phone:
Name:
Address:
City:
Country:
E-mail:
Cell:
Province:
Postal Code:
D - Health & Safety Information
Phone:
Alberta Health Care #:
Family Doctor:
Emergency Contact:
Relationship to Camper:
Phone:
Cell:
- Does your camper have any special dietary needs?
- Does your camper have any concern regarding health?
- Does your camper have any medical condition or allergies?
- Will your camper be on any medication while at camp?
In the unlikely event of an emergency, every effort will be made to contact a parent, caregiver, or the emergency contact. If neither parent, caregiver, nor emergency contact can be reached in the event of an emergency, I hereby give permission for my camper to be medically attended to as deemed appropriate by the Camp Director, including, as necessary, hospitalization.
E - Payment Information
To ensure you camper's participation, please send a cheque in the amount of $50 as a non-refundable deposit to the camp registrar. Balance of the payment is due upon registration.
Janice Vitt
#289, 53310 - Range Road 221
Ardrossan, Alberta T8E 2L2
Make your cheque payable to:
Van Es Camp & Conference Centre
Van Es Camp & Conference CentrePlease indicate the name and the age of your camper on your cheque.
F - Submit Your Form
- Once completed, send your information by pressing SUBMIT
- To clear the form and begin a new registration, press RESET
- For a paper copy of the registration form, click here...
- For online registration, see below.
Note: Please consider reviewing the Summer Camp FAQs as they may address many of your questions.
