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Personal Info

First name:

For robotic computers. If you can see this, leave this field blank:

Last name:

Church:

I am a baptized or professing member of:

Gender:

Birth Date:

Email Address:

Phone Number:

I am NLS certified, and may be willing to be a lifeguard at camp.

I am certified in First Aid.

Mailing Address

House Number & Street:

City:

Province/State:

Postal Code:

Emergency Contacts

Contact 1 Name:

Relationship to you:

Daytime Phone #:

Nighttime Phone #:

Contact 2 Name:

Relationship to you:

Daytime Phone #:

Nighttime Phone #:

Medical Information

We collect this information in order to ensure your safety while at camp - in case of emergency or for things like food preparation. Please ensure this information is accurate! See our Privacy Policy for details on how we handle your data. Also, note that while we request your Health Card number for emergencies, we do not require it.

Health Card #:

Do you have any health issues that might prevent you from taking part in any of the activities at camp? Any known allergies? Any prescription medications we need to be aware of?

American Campers

Insurance Carrier:

Policy Number:

Workshop Selection

Please note that you will be able to change your choices up to three weeks in advance of camp. A link will be available on the main page. Also, due to size limitations, sometimes you won't get in the workshops you signed up for.

Workshop 1

Workshop 2

Alternate Workshop

Verification

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