TVBC Teen Camp Registration 2021

您的浏览器中未启用 JavaScript，因此无法打开此文件。请启用 JavaScript，然后重新加载。

电子邮件地址 *

I, the parent/guardian, have read the COVID-19 statement above. *

By checking this box, I confirm I have read the COVID-19 statement above.

必填

I would like to register my camper for: *

Ball Hockey Teen Camp (June 27th - July 2nd)

Adventure Teen Camp (July 4th - 9th)

Traditional Teen Camp (July 11th - 16th)

必填

Camper's First & Last Name *

Male or Female *

Male

Female

Camper's Date of Birth *

年

月

日

Camper's Age *

其他:

必填

Street Address, City, Province, Postal Code *

Home Phone *

Work/Cell Phone (Parent/Guardian) *

Emergency Contact's Name and Relationship to Camper *

In the event of an emergency we will contact the parent/guardian first using the phone numbers submitted above. If we are unable to make contact with the parent/guardian at the phone numbers listed above we will then use the emergency contact listed.

Emergency Contact's Phone *

Camper's Med. # and Exp. Date (If from U.S. state health insurance provider) *

Please List Known Allergies *

If there are no known allergies please respond with "N/A"

Please list medications and dosages. (Medications must be turned in to registrar upon arrival in their original container with clear written instructions.) *

If there are no medications please respond with "N/A"

Please indicate if your child has a history of any of the following: *

Diabetes

Bed Wetting

Sleep Walking

Asthma

Ear/Stomach Aches

Homesickness

Agressiveness

A.D.H.D.

N/A

其他:

必填

清除表单内容

切勿通过 Google 表单提交密码。

此内容不是由 Google 所创建，Google 不对其作任何担保。举报滥用行为 - 服务条款 - 隐私权政策

表单