Camp Caravan 2022 Registration Form Fill out the online form BELOW and pay with your credit card.OR Download the PDF Registration form and mail the completed form with payment to the address provided – 2022 Registration Form Summer Camp Caravan Registration - 2022 Please complete this form to register your child(ren) for Summer Camp Caravan. Thank you! Week(s) attending Camp* July 4 - 8, Fish Creek United Church, 77 Deerpoint Rd SE (FULL) July 11 - 15, Fish Creek United Church, 77 Deerpoint Rd SE July 25 - 29, Hillhurst United Church, 1227 Kensington Close NW, Calgary AB, T2N 3J6 August 8 - 12, Spring Bank United Church, 250011 Range Rd 33, Calgary AB, T3Z 1L2 August 15 - 19, St. Andrew's United Church, 128 1 St E, Cochrane AB, T4C 1Z3 August 22 - 26, Scarboro United Church, 134 Scarboro Ave SW, Calgary AB, T3C 2H1 Select the week(s) that your child(ren) will attend camp and the remainder of the payment form will appearFamily InformationName of Parent / Guardian* First Last Phone 1*Family Email Address* Name of Parent / Guardian (optional) First Last Phone 2 (optional)Camp: July 4 - 8, 2022 (FULL)# of Children Attending - July 4 - 8, 2022*Please enter a number from 1 to 20.Enter the number of children that will be attendingInformation for Child(ren) Attending - July 4 - 8*First NameLast NameGenderAHC# (required)AgeDate of Birth (mm/dd/yy)Allergies & Other ConcernsIf possible, please place in a group with * Enter the information for each child who will be attending this week. Use the plus button on the right of the fields to add an extra row for each child. *Group Placements: Note, we will do our best to accommodate special requests regarding children’s group placements. Your having made the request does not constitute a promise made to your child. Thank you for your understanding if we are unable to accommodate your request.Camp Cost* Price: $ 100.00 CAD Camp cost per week is $0/child.Camp: July 11 - 15, 2022# of Children Attending - July 11 - 15, 2022*Please enter a number from 1 to 20.Enter the number of children that will be attending camp this week.Information for Child(ren) Attending - July 11 - 15, 2022*First NameLast NameGenderAHC# (required)AgeDate of Birth (mm/dd/yy)Allergies & Other ConcernsIf possible, please place in a group with * Enter the information for each child who will be attending this week. Use the plus button on the right of the fields to add an extra row for each child. *Group Placements: Note, we will do our best to accommodate special requests regarding children’s group placements. Your having made the request does not constitute a promise made to your child. Thank you for your understanding if we are unable to accommodate your request.Camp Cost* Price: $ 125.00 CAD Camp cost per week is $0/child.Camp: July 18 - 22, 2022# of Children Attending - July 18 - 22, 2022*Please enter a number from 1 to 20.Enter the number of children that will be attending camp this week.Information for Child(ren) Attending - July 18 - 22, 2022*First NameLast NameGenderAHC# (required)AgeDate of Birth (mm/dd/yy)Allergies & Other ConcernsIf possible, please place in a group with * Enter the information for each child who will be attending this week. Use the plus button on the right of the fields to add an extra row for each child. *Group Placements: Note, we will do our best to accommodate special requests regarding children’s group placements. Your having made the request does not constitute a promise made to your child. Thank you for your understanding if we are unable to accommodate your request.Camp Cost* Price: $ 125.00 CAD Camp cost per week is $125/child.Camp: July 25 - 29, 2022# of Children Attending - July 25 - 29, 2022*Please enter a number from 1 to 20.Enter the number of children that will be attending camp this week.Information for Child(ren) Attending - July 25 - 29, 2022*First NameLast NameGenderAHC# (required)AgeDate of Birth (mm/dd/yy)Allergies & Other ConcernsIf possible, please place in a group with * Enter the information for each child who will be attending this week. Use the plus button on the right of the fields to add an extra row for each child. *Group Placements: Note, we will do our best to accommodate special requests regarding children’s group placements. Your having made the request does not constitute a promise made to your child. Thank you for your understanding if we are unable to accommodate your request.Camp Cost* Price: $ 100.00 CAD Camp cost per week is $125.00/child.Camp: August 2 - 5, 2022 * (Short Week due to Heritage Day)# of Children Attending - August 2 - 5, 2022*Please enter a number from 1 to 20.Enter the number of children that will be attending camp this week.Information for Child(ren) Attending - August 2 - 5, 2022*First NameLast NameGenderAHC# (required)AgeDate of Birth (mm/dd/yy)Allergies & Other ConcernsIf possible, please place in a group with * Enter the information for each child who will be attending this week. Use the plus button on the right of the fields to add an extra row for each child. *Group Placements: Note, we will do our best to accommodate special requests regarding children’s group placements. Your having made the request does not constitute a promise made to your child. Thank you for your understanding if we are unable to accommodate your request.Camp Cost* Price: $ 125.00 CAD Camp cost per week is $100.00/child.Camp: August 8 - 12 , 2022# of Children Attending - August 8 - 12, 2022*Please enter a number from 1 to 20.Enter the number of children that will be attending camp this week.Information for Child(ren) Attending - August 8 - 12, 2022*First NameLast NameGenderAHC# (required)AgeDate of Birth (mm/dd/yy)Allergies & Other ConcernsIf possible, please place in a group with * Enter the information for each child who will be attending this week. Use the plus button on the right of the fields to add an extra row for each child. *Group Placements: Note, we will do our best to accommodate special requests regarding children’s group placements. Your having made the request does not constitute a promise made to your child. Thank you for your understanding if we are unable to accommodate your request.Camp Cost* Price: $ 100.00 CAD Camp cost per week is $125/child.Camp: August 15 - 19, 2022# of Children Attending - August 15 - 19, 2022*Please enter a number from 1 to 20.Enter the number of children that will be attending camp this week.Information for Child(ren) Attending - August 15-19, 2022*First NameLast NameGenderAHC# (required)AgeDate of Birth (mm/dd/yy)Allergies & Other ConcernsIf possible, please place in a group with * Enter the information for each child who will be attending this week. Use the plus button on the right of the fields to add an extra row for each child. *Group Placements: Note, we will do our best to accommodate special requests regarding children’s group placements. Your having made the request does not constitute a promise made to your child. Thank you for your understanding if we are unable to accommodate your request.Camp Cost* Price: $ 125.00 CAD Camp cost per week is $125/child.Camp: August 22 - 26, 2022# of Children Attending - August 22-26, 2022*Please enter a number from 1 to 20.Enter the number of children that will be attending camp this week.Information for Child(ren) Attending - August 22-26*First NameLast NameGenderAHC# (required)AgeDate of Birth (mm/dd/yy)Allergies & Other ConcernsIf possible, please place in a group with * Enter the information for each child who will be attending this week. Use the plus button on the right of the fields to add an extra row for each child. *Group Placements: Note, we will do our best to accommodate special requests regarding children’s group placements. Your having made the request does not constitute a promise made to your child. Thank you for your understanding if we are unable to accommodate your request.Camp Cost* Price: $ 125.00 CAD Camp cost per week is $125/child.Emergency ContactParent/Guardian Name(s)* First Last Phone 1*Phone 2Non-Family Contact Name(s)* First Last Phone 1*Phone 2Child Security & SafetyName of Adult Picking Up Participant(s)* First Last Secondary Adult (if applicable) First Last Are there any persons NOT permitted to pick up Participants?* Yes (provide names below) No If yes, provide name(s) here* Does your child use special medication ie. Epi-pen, Asthma Inhaler?* Yes No Please complete the Severe Allergy Alert Form on this website. Click here to open the Severe Allergy Alert form in a new/window tab.Parental AuthorizationParental Authorization Photography Release – I give permission for Camp Caravan/Fish Creek United Church/St. Andrew’s Regional Ministries to use any photographs, video tapes or audio tapes that may be taken of my child(ren) while attending Camp Caravan 2022 for promotional or educational purposes. I agree that the photos, video footage and/or audiotape may be used without limitation on time or frequency. Waiver – I acknowledge that Camp Caravan/Fish Creek United Church/St. Andrew’s Regional Ministries and Staff/Volunteers are not responsible for loss, theft or damage to personal property or any bodily injury suffered by participating, before, during or after the program, unless such injury is the direct and sole result of proven negligence on the part of Camp Caravan/Fish Creek United Church/St. Andrew’s Regional Minsitries. Consent – I hereby give permission for the Camp Caravan/Fish Creek United Church/St. Andrew’s Regional Ministries Staff/Volunteers to act in my place in the event my child(ren) should require medical care, if I cannot immediately be reached.Refund Policy - Cancellations received one month before the start date of registered Camp Caravan session will receive a full refund. We are unable to provide a refund for those cancellations made within one month of the start date of a Camp Caravan session.Confirmation - Your child is not considered registered until you have received an emailed confirmation after payment. Signature of Parent/Guardian* First Last Date of Signature* MM slash DD slash YYYY PaymentTotal Cost for camp(s) $ 0.00 CAD The total cost for the camp(s) selected.Credit Card*Card Details Cardholder Name EmailThis field is for validation purposes and should be left unchanged. Share this:TweetMorePrintPocketShare on Tumblr
