2022 Camper Registration Form

Camper Registration Form for Ages 5-10

* Indicates required field

Child's Name *

Address: *

Parent/Guardian Name (first/last): *

First

Last

Home Phone *

Work Phone: *

Cell Phone: *

City: *

Postal Code: *

Email *

Age: *

Sex: *

Male Female

Date of Birth (DD/MM/YYYY): *

T-shirt Size (We may need this if we decide to purchase camp t-shirts) *

Medical Information

Allergies: *

Emergency Contact: *

Emergency Contact Phone: *

Emergency Contact Relation to Child: *

Names of Those Approved to pick up your child/ren *

I hereby give permission for the person registered via this form to participate in all activities, to have
photographs taken of them for advertising purposes, and to receive emergency medical treatment if
necessary.

Check to give permission: *

I give Permission:

Comment *

The cost for the week is $80.00
Please make cheques payable to Trinity Anglican Church.
You can drop the form and cheque off at the Church office in the mailbox, or register and pay online through the website: www.trinitysarnia.org, you can also pay through email money transfer to trinity@trinitysarnia.org, no password is needed.
If you would like to make sure your child is with a specific friend or family member please indicate below. We cannot guarantee they will be in the same groups but we will make our best efforts.

Pair my child with: *

Submit

Sign up today!

July 11-15, 2022
8:45am - 3:00pm

Camper Registration Form for Ages 5-10

Medical Information

​Sign up today!

July 11-15, 20228:45am - 3:00pm

Camper Registration Form for Ages 5-10

Medical Information

Sign up today!

July 11-15, 2022
8:45am - 3:00pm