Fellowship Bible Church + Baden Central Church - Baden Summer Camp Registration

Baden Central Arts and Crafts Camp - Registration

Date: August 11-15, 2025
Time: Drop Off @ 9:00am - Pick Up @ 12:00pm
Drop Off & Pick Up @ Baden Central Church (44 Beck St.)

*Please note, campers will be responsible to bring a snack as food will not be provided.

Name of Child:

Gender

Address:

Postal Code:

Age:

Cell/Home Number:

Emergency Contact's Name:

Emergency Contact's Phone Number:

Emergency Contact's Relationship with Child:

Does your child have any severe allergies (bee stings, food, penicillin, other drugs)?

Yes

No

If yes, please explain:

Does your child have any life-threatening allergies?

Yes

No

If yes, please explain:

Is your child bringing any medication with him or her (antibiotics, ventilator, Ritalin, Episode-Pen)?

Yes

No

If yes, please explain:

Does your child have any physical, emotional, mental or behavioural concerns or limitations that our staff should be aware of?

Yes

No

If yes, please explain:

Provincial Health Insurance or equivalent medical insurance must cover your child.

Health Card Number:

Precautions are taken for the safety and health of your child, but in the event of accident or sickness, Baden Central Church, its staff, and its volunteers are hereby released from any liability. In the event that your child requires special medication, x-rays or treatment, the parents/guardians will be notified immediately.

Signature

Date of Signature