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Adore Kids Soccer Daycamp Registration

Ages 6-10, August 18-20, 10 am - 3 pm
$25 each (includes your own soccer ball, t-shirt & snacks)
Bring: lunch, running shoes & sunscreen!
For more info call the GT Office (250-384-7633) or e-mail lisahart@islandnet.com
Name of Child:
Age:
Contact E-mail:
Phone:
Address:
Parent/Guardian Name:
Daytime Phone:
Cell Phone:
Does your child have any severe allergies?
(bee stings, food, penicillin etc.)
If yes, please explain?
Other pertiment medical information: (medications, conditions, other)
Care Card Number:
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:
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1800 Quadra Street, Victoria, BC Canada V8T 4B9 |  Phone: 250.384.7633 |  Fax: 250.384.0113 | gtidings@gtvictoria.com