Wilderness Escape VBS Registration
Wilderness Escape hosted at St Andrew's Fergus will run from July 5 to 9, from 9am to 11:30am. Our camp is geared for ages five to eleven. We'll enjoy crafts, games, bible teaching, and song. We'll follow your registration up with a confirmation email within one week. Looking forward to camp!
Camper's first and last name *
Camper Date of Birth (d/m/yr) *
Camper Home Address:* *
Parent/Guardian Name: * *
Parent Daytime Emergency Phone: * *
Parent Email *
Emergency Contact Information -- If your camper emergency contact is someone other than the parent or guardian listed here, please enter contact: Name, Phone, and Relationship to camper.
Medical Information -- Please indicate any allergies your child may have, any health conditions camp staff should be aware of, relevant medications your child is taking, or any medical statuses that may affect your child's ability to participate in camp activities.
Camper Health Card Number - We recommend providing a health number in case of emergency where you cannot be reached:
Legal Release -- I am the legal guardian of the camper with full authority to make decisions with respect to the care, upbringing, and education of the applicant.  I agree and comply that all of the medical information provided on this form is true and accurate – lacking nothing.  I give permission for my child to participate in all camp activities. I release my child to the care and medical discretion of the staff/volunteers at St Andrew’s.  In the event of an emergency and that no one can be immediately contacted, my child will be taken to the hospital or a physician to be treated if deemed necessary by one of the church staff or volunteers.  I authorize the physician and nursing staff to undertake examination, investigation and necessary treatment of my child. I give permission for the above child to participate in all camp activities and to receive emergency medical treatment if necessary. I release St Andrew’s Presbyterian, and all VBS staff and volunteers from liability. Please type your signature: *
Photo Release -- By checking ‘yes’ you give permission for your child to appear in photos from sports camp, displayed in slideshows or bulletin boards at the church. *
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