Surf's Up 2016 Camp Title

 

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Date: August 8-12, 2016

Time: 10am - 12pm

Location: Aldergrove Athletic Park Picnic Shelter

(26845 27th Ave, Langley, BC)

Ages: 5-11  |  Cost per child: $5

Join us for some summer FUN!  There will be water games, kids activities and snacks are provided!

We can only accept COMPLETE Registrations.  (Medical Numbers and payment for each registrant are required)

Surf's Up Camp Director: Julie Furtado

Today's Date
Parent / Guardian Information
Parent / Guardian First Name
Parent / Guardian Last Name
Cell Phone*Called first in emergency situations
Home Phone*Called second in emergency situations
Sign up to receive emails about other exciting children's events like this!
Street Address
City
Province
Postal Code
I attend CLCC Aldergrove Campus:

Welcome!  We are so glad you are registering!  We give special priority to kids who don't have a home church.

Home Church
Emergency Contact

This emergency contact person must be someone other than yourself (it could be another parent/guardian, a relative or close family friend).  We will always attempt to contact you first should an emergency arise.

Emergency ContactPlease include their first and last name.
Home / Cell Phone*Called if we can't reach you first!
Relation to child(ren):
Waiver

I (the parent/guardian named above) authorize the Surf's Up Camp Director: Naomi Heith and/or one of the Christian Life Community Church ministry staff to sign a consent for medical treatment and to authorize any physician or hospital to provide medical assessment, treatment or procedures for any of the participants listed on this registration.

I (the parent/guardian named above) undertake and agree to indemnify and hold blameless Christian Life Community Church, its pastors, representatives, staff, volunteers, and Leadership Council against any loss, damage or injury suffered by the participant(s) as a result of taking part in the activities of the Church, as well as any medical treatment authorized by the supervising individuals representing the Church. This consent and authorization is effective only when participating in or traveling to events of Christian Life Community Church. 

I (the parent/guardian named above) grant permission to Christian Life Community Church to photograph/record my child during this event and to use these photos/video recordings for the purposes of CLCC Summer Camp promotional materials (i.e. brochures, posters, church slideshows, videos etc.) and I/we acknowledge that these photos and/or videos may be viewed online (i.e. CLCC Website, Facebook, CLCC Vimeo Channel etc.). Please note: we do our best to protect your identity and privacy by avoiding the use of names and personal identifiers.

I agree to the Waiver above:
Children's Information

Aldergrove's Surf's Up Camp is for children ages 5-11.  Sorry, there is no Pre-K Group for this camp.

Child 1
First Name
Last Name (if different from your own)
Birthdate
Gender
Medical Number
Are there any medical, physical, emotional, mental and/or behavioural conditions or concerns or allergies that we should be aware of?Additionally, please list any medication your child will be bringing with them to camp.
0 /
Child 2
First Name
Last Name (if different from your own)
Birthdate
Gender
Medical Number
Are there any medical, physical, emotional, mental and/or behavioural conditions or concerns or allergies that we should be aware of?Additionally, please list any medication your child will be bringing with them to camp.
0 /
Child 3
First Name
Last Name (if different from your own)
Birthdate
Gender
Medical Number
Are there any medical, physical, emotional, mental and/or behavioural conditions or concerns or allergies that we should be aware of?Additionally, please list any medication your child will be bringing with them to camp.
0 /
Child 4
First Name
Last Name (if different from your own)
Birthdate
Gender
Medical Number
Are there any medical, physical, emotional, mental and/or behavioural conditions or concerns or allergies that we should be aware of?Additionally, please list any medication your child will be bringing with them to camp.
0 /
Payment Information

Once you click "Submit Form" you will be automatically redirected to login to PayPal to complete your registration Payment.  If you have any questions or concerns about registration or payment, please contact Julie Furtado.

Sorry, we cannot give refunds for cancellations.

RegistrationQtyTotal
Aldergrove's Surf's Up Camp Registration[field164][field164*5]

Now What?

You will be receiving an email shortly to verify that we have received your online registration.  Once we've processed your registration, confirmed your spot and received payment, we will email you to confirm your registration.  (If you don't hear from us, check your junk mailbox or email julie@clcc.ca with any registration questions or concerns you may have.

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