Camp Big Canoe

Registration Notes:

This form is for the summer of 2010.
This is an "online" registration. You may elect to print the form, and send it to the Registrar.
A separate form and fee are required for each child and each camp session.
Online registrations will not be processed until the deposit has been received by the Registrar through mail or phone.

Camper's Name:
Address:
City:
Postal Code:
Home Phone:
Parent/Guardian 1 :
Work Phone:
Parent/Guardian 2 :
Work Phone:
Email:
Emergency Contact:
Phone Number:
Sex:	Male Female
Birth Date:
Age:	as of June 30/2010

Camp Session Desired:	(see list of sessions & pricing)
1st Choice:
2nd Choice:
Bus TO Camp ($30):	Yes No Not avaliable for second one-week session.
Bus FROM Camp ($30):	Yes No Not avaliable for first one-week session.
Mail receipt to:
Church attended (if any):
Denomination:

How did you hear about the camp?

Friend (name):
Relative:
Church:
Media:
Other:

Conditions of Enrollment

The Camp Director reserves the right to dismiss a camper who, in his/her opinion, has displayed unacceptable behaviour and/or has not complied with the rules of the camp.
The parent(s) or guardian(s) submitting this application are those having legal custody over the child. Conditions of custody and access, if applicable, should be fully communicated in writing to the camp.
I hereby give permission and the legal right for Camp Big Canoe for use and ownership of any written or audio-visual material and photographs of the above named camper for publicity and promotional purposes.
I have read this application form and I understand and accept the conditions of enrollment.

Date: Check here to accept the terms of the Conditions of Enrollment. This registration cannot be processed otherwise.

Please Note: This application must be accompanied (through mail or by phone in the case of VISA or M/C) by a deposit of $250.00 for each session a camper is to be registered in and a postdated cheque for the balance, dated May 15, 2010. This application for will not be processed until the deposit has been received by the Registrar. Prior to May 15th, there is a $60.00 cancellation fee. After May 15th, the $250.00 deposit is not returnable. In the case of withdrawal during camp on a physician's order, two-thirds of the fee for the unexpired term will be refunded. No refunds will be made for dismissals due to disciplinary action, late arrivals or early departures.

Please make cheques payable to:
Camp Big Canoe, and write the name of the Camper and the session(s) desired on the back of the cheque.