CAMPER REGISTRATION

Primary Phone Number *

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Booster Seat *

Does your child require a booster seat in a vehicle?

Yes

No

Teen Paintball

Only available for Teen Camp: $40 fee. Additional hoppers may be available at an extra cost (cash only).

Yes

No

I give permission for the nurse(s) to administer medication to my child if/when needed.

Yes

Swimming *

At camp we use the Frenchman River for swimming. The water can be fast moving and deep. Does your child require a life jacket in the river?

Yes

No

Emergency Contact *

First Name

Last Name

Phone *

(###)

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Doctors Name *

First Name

Last Name

Phone *

(###)

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Waiver *

By clicking 'accept' at the bottom of this form, I understand that I, the undersigned parent/legal guardian of the child named on this form, authorize said child's full participation in Valley View Bible Camp, including related camp activities. It is my understanding that participation in the activities that make up VVBC are not without some inherent risk of injury. As such, in consideration of my child's participation in VVBC, I hereby release, waive, discharge, and covenant not to sue the camp program, Valley View Bible Camp, their officers, servants, agents, or employees from any and all liability, claims, demans, action and cause of action whatsoever arising out of or related to any loss, damage, injury, including death, that may be sustained by my child, whether caused by the negligence of the releases, or otherwise while participation in any such activity is being conducted. I also give permission for any emergency medical care of treatment by a physician, surgeon or hospital , or medical care facility that may be required, including transportation, and accept responsibility for the cost. I also understand that the medical insurance policy carried by VVBC, if any, will provide only minimum coverage and that I should make sure my child is covered with Provincial private family insurance in the event of a serious accident.

I Accept

I Decline

Photographic Release *

By clicking accept, I understand that Valley View Bible Camp may record my child's participation in camp on video, photograph or other electronic means. I grant VVBC unlimited use of any such recordings with non-obilgation to me. Such recordings are the sole property of VVBC.

I Accept

I Decline