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youth

City Youth Camping Trip - August 6-8
at the Selah Campgrounds in Courtenay: Cost $40

Student's Full Name:
Age
E-mail:
Phone Number:
Parent/Guardian Name:
Parent Cell:
Any Allergies?:
(bee stings, food, penicillin, etc?)
If yes, please explain:
Any other medical information?:
Care Card Number:
 


PARENTS:
Precautions are taken for the safety and health of your child, but in the event of and accident or sickness, Glad Tidings Church, its' staff, and its' volunteer workers 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. Your child must be covered by Provincial Health Insurance or equivalent medical insurance.
I have read and understood this information:
Today's Date:
 
 
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