Sr. Youth Camping trip

Standard ticket

$20.00

Prices are in CAD.

Who’s this registration for?

First name

Last name

Email address

Contact phone

Student Declaration

As a participant in FBC Youth at Youth Quake, I will fully cooperate with the leaders, rules, and program established for the retreat in order to ensure its success.

By checking this box, I am agreeing to abide by the terms of the above declaration.

First Name

Last Name

Date

Student Information

Gender

Male Female

Grade

9 10 11 12

Medical Information

Health Card #

Full Name on Health Card

Is there any other medical information that we should be aware of? (e.g. allergies, injuries, medical conditions, non-prescription medication, etc.)

Is the student on prescription medication? If yes, please list exactly what and when it is to be taken.

Parent/Guardian Information

First Name

Last Name

Relationship to Student

Phone #1

Phone #2

Phone #3

Alternate Emergency Contact

First Name

Last Name

Relationship to Student

Phone #1

Phone #2

Phone #3

Parent/Legal Guardian Authorization for Participation in FBC Youth Sr Youth Camping Trip 24

I give my permission for my son/daughter to participate in Senior Youth Camping Trip 2024. I understand the possibility of unforeseen hazards and know the inherent possibility of risk. I agree that I will not hold First Baptist Church, its leaders, employees, or volunteer staff liable for damages, losses, diseases, or injuries incurred by the subject of this form. I grant my son/daughter permission to participate in all regular activities of the trip. In the event that my son/daughter is injured and requires the attention of a doctor, I consent to any reasonable medical treatment as deemed necessary by a licensed physician. In the event treatment is required from a physician and/or medical personnel designated by First Baptist Church, I agree to hold such person free and harmless of any claims, demands, or suits for damages arising from the giving of such consent. I also agree to bring my child home at my own expense should they become ill or if deemed necessary by FBC Youth leadership.

As the parent of a student at the FBC Youth Sr. Youth Camping Trip, I agree to the terms of the above agreement.

Parent First Name

Parent Last Name

Date

Booking details

Who’s this registration for?

Student Declaration

Student Information

Medical Information

Parent/Guardian Information

Alternate Emergency Contact

Parent/Legal Guardian Authorization for Participation in FBC Youth Sr Youth Camping Trip 24

Contact the event organizer