Family Camp Registration

* Indicates required field

First Name *

Last Name *

Age *

Alberta Health Care Number *

First Name *

Last Name *

Age *

Alberta Health Care Number *

First Name *

Last Name *

Age *

Alberta Health Care Number *

First Name *

Last Name *

Age *

Alberta Health Care Number *

First Name *

Last Name *

Age *

Alberta Health Care Number *

First Name *

Last Name *

Age *

Alberta Health Care Number *

Address *

City *

Province *

Postal Code *

Cellular Phone Number *

Home Phone Number *

Work Phone Number *

Email *

Dietary Restrictions *

Yes No

If yes, please explain in detail all restrictions. *

Do you have a family that you would like to share a cabin with? If yes, please give us the family name, and we will do our best to accommodate your request. *

Canyon Church Camp Authorization and Consent

Family Registration: I acknowledge that I and the members of my family named herein are subjected to the rules and regulations of Canyon Church Camp. In the event I am unable to provide consent in the Medical Emergency, I hereby give permsission that medical treatment be obtained. I agree to pay any charges not covered by my Medical Plan, ie. medications, ambulance, etc. I hereby waive all claims against the Canyon Church Camp Association, and is representatives, for any accident or injury that may occur in connection with the events for which I and my family have registered.

I consent that images may be used for camp promotion promotion unless written objection is provided to the Registrar.

I have read the above Canyon Church Camp Authorization and Consent, and agree to abide by all rules and regulations as outlined. I fully understand that submitting this form will be accepted as my legal signature on the form. *

Yes

Your Name *

Date *

Comment *

To ensure payment has been received, please specify the email address you will be using for Pay Pal. *

Please note: Placement of camp cannot be confirmed until payment is recieved.

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Family Camp Registration

​​Canyon Church Camp Authorization and Consent

Canyon Church Camp Authorization and Consent