Silver Birches Kids' Camp 2023 Online Registration
July 3-7
Ages 7-12
Registration - Monday 2-4 p.m.
Closing Program - Friday 5 p.m.
Check-out - Friday 6 p.m.

Theme Night is Carnival, and the main verse is Proverbs 1:22

Early Bird Registration before June 19th - $220 + $5 tuck credit
Regular rate - $250 
Three or more siblings $10/child discount
E-Transfer - kidscampregistration@outlook.com

One registration per child.
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Camper's Name *
Gender *
Birthday *
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/
DD
/
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Age *
Address *
Swimming Lessons *
Level
E-mail *
Parent/Guardian Name *
Phone Number *
Mailing Address *
Medical Info (Check all that apply) *
Required
Will your child require medication? *
If yes, please give details
Does your child have any emotional/physical/learning challenges? *
If yes, please give details and will medication be needed?
Tetanus shot within five years? *
Can Tylenol be given? *
Dietary Needs? *
If yes, please explain
Health Card Number + Version Code *
Doctor's Name + Number *
Roommate Choice - We do all we can to match your child with their choice of roommate. On registration day, there will be no room changes. *
Emergency Contact #1 (Name, Relationship, Phone Number) *
Emergency Contact #2 (Name, Relationship, Phone Number) *
I understand every precaution to ensure the welfare and protection of each camper and staff at Silver Birches. They are free from any liability in the event of a medical emergency. I understand they will try to contact parents/guardians. If I cannot be reached, or to contact me would be a significant delay for required medical treatment, I permit the staff to secure the services of a licensed physician to provide the care necessary, including any anesthetics or surgery, for my child’s wellbeing. If my child should require basic medical treatment (sore throat, rash, earache), I permit the staff to secure proper treatment.  Parent/Guardian Name is filled in here. *
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