Registration Form For Spring Break Camp March 14-16
Name __________________________________________________________________
Address ________________________________________________________________
City ___________________________________________________________________
Postal Code ____________________ Phone ( ) __________________________
Medical Insurance # _______________________________________________________
Known Allergies __________________________________________________________
Age ___________ Male __________ Female __________
Date of Birth: D: ______ M: ______________ Y: ___________
Home Church ____________________________________________________________
As a camper, I will cheerfully follow the rules set
out by the Camp Leadership.
Signature: ________________________________________________________
$20
Non-refundable registration fee PER camper enclosed? ____________
Part of camp fee OR Total Camp Fee enclosed? ___________
Registration Time: 3:00 pm March 14th
Camp Ends: After lunch on March 16th
*NO PETS
Mail to:
COWICHAN RIVER BIBLE CAMP
5070 West Riverbottom Road
Duncan,
B.C. V9L 6J6
Phone (250) 746-7258 Fax (250) 746-7321