Facebook  YouTube Contact Us

Registration: March Break Winter Day Camp (Ages 5-12) (Mar 5, 2018 - Mar 9, 2018 AST)

We are very excited to offer, for the first time, March Break Day Camp! Our summer day camps have been growing for three years and now we are offering an opportunity to have have the benefits of summer...in the cold of winter!  

 

USER INFORMATION
Parent's / Guardian's or Adult Camper Information
Title:
Parent's/Guardian's/Adult's First Name:
Parent's/Guardian's/Adult's Last Name:
Primary Phone :
Secondary Phone :
Other Phone :
Email:
Confirm Email:
Address:
Address 2:
City:
Province::
Postal Code:
1
Camper's Information
Camper's First Name:
Camper's Last Name:
Camper's Sex:
Male  Female  
Camper's Age:
Camper's Birthday:
   
Camper's Medical Information
Provincial Medicare Number:
Province of Medical:
Medicare Expiry Date (MM/DD/YYYY):
Health Concerns:
Does the camper have allergies?:
Medications coming to camp with complete dosage and delivery instructions.:
Do you give Hampton Bible Camp permission to give over-the-counter medications to your child/adult camper (i.e.; Tylenol (acetaminophen), Benadryl (diphenhydramine), Pepto Bismol, or Tums (antacid)?:
Yes  
Yes - with a phone call  
No  
Camper Lives With:
Comments or special requests:
I, the PARENT/GUARDIAN, have read and agree to the Assumption of Risk Form:
Yes
I, the PARENT/GUARDIAN, have read and agree to the Parent Permission Form:
Yes
Enter the Security Code:

Sign up to get our newsletter!