BCIT

Camper Information

 
Camper First Name:
Camper Last Name:
Date of Birth:
Home address:
City:
Province:
Postal Code:

Please identify any food allergies or medical issues:

Camp Options.  Please choose one and fill out one form for each camp spot.

Ages 8 - 12 Camps

Ages 13 - 17 Camps

Is After Camp Care Required?
Yes
No

Lunch options are under review.  Would you like to receive information about lunch?
Yes
No

Parent / Guardian Information:

 
Name:
Email:
Phone Number:

Relationship to camper:
Mother
Father
Other (please specify) 

Emergency Contact Information #1:
Full Name:
Phone Number:
Relationship to Camper:

Emergency Contact Information #2:
Full Name:
Phone Number:
Relationship to Camper:

Authorized Pickup #1:
Full Name:
Phone Number:

Authorized Pickup #2:
Full Name:
Phone Number:

                   

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