Online Registration (Events and Retreats)

If registering for SUMMER CAMP, please click here for the SUMMER CAMP registration form.
If registering for FAMILY CAMP, please click here for the FAMILY CAMP registration form.

Your Email:

Registrant Information

Name of Program or Event (PLEASE ENTER)

First Name

Last Name

Gender

Birthdate

Personal Information

Address

City

Province

Postal Code

Country

Phone

Fax

Home Church (if applicable)

Emergency Contact Person

(should we not be able to get ahold of the numbers listed above)

Emergency Contact 1 Full Name

Relationship to Registrant

Home Phone

Work/Cell Phone

Emergency Contact 2 Full Name

Relationship to Registrant

Home Phone

Work/Cell Phone

Doctor's Name

Doctor's Phone

Care Card/ Insurance #

Additional Information

Is this your first time at Camp Columbia?

How did you hear about us?

Name of preferred Roommate 1 (if applicable)

Name of preferred Roommate 2 (if applicable)

Medical Information

Do you have any special needs requests

If yes please provide details

Allergies or Medically Prescribed Diet?

Payment Info

Cheque* Visa American Express Mastercard

Card Number - - -

Expiry Date /

Name on Card

Amount to charge

* If paying by cheque please remember that a registration is not secured until we have received payment and a signed health form.

Box must be checked to submit the form

I understand that by submitting this form I am in agreement with the following terms and conditions as listed below and certify that I am of legal consent (age 19 or older):

I understand my child/self/ward may be photographed at Camp and that the photographs may be used in future Camp Columbia publications.

Family I	All Ages	Jun28 - Jul3
Family II	All Ages	Aug 2-7
Junior Coed I	9-11	Jul 5-10
Senior Coed I	11-14	Jul 12-17
Juan De. Trail	13-16	Jul 12-17
Girls Camp	10-14	Jul 19-24
Boys Wilder.	9-12	Jul 19-24
Teen Camp	13-16	Jul 26-31
Theatre Camp	12-16	Aug 2-7
7s 8s 9s	7-9	Aug 10-14
Mini Adv. I	7-11	Jul 16-19
Sr. Coed 2	11-14	Aug 23-28
LIT 1	15-17	Jun28-Jul17
LIT 2	15-17	Aug 2-22