Online Registration

If registering for a non-summer program, please click here to go to the "retreats" form.

Family Email:

Camper Information

First Name

Last Name

Gender

Birthdate

Family Information

Address

City

Province

Postal Code

Country

Phone

Fax

Home Church (if applicable)

Mother's Name

Mother's Home Phone

Mother's Work Phone

Father's Name

Father's Home Phone

Father's Work Phone

Family Cell Phone

Doctor's Name

Doctor's Phone

CareCard/ Insurance #

Emergency Contact Person

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

Name

Relationship to Camper

Home Phone

Alternative Phone

Legal Custody

If other, please specify

Additional Information

Is the child a first time camper?

How did you hear about us?

Name of preferred Cabin Partner 1

Name of preferred Cabin Partner 2

T-shirt size

Please note tshirts are only included with summer registrations.

Medical Information

Please note, you will be required to fill in a more detailed medical form closer to camp to ensure we have the most up-to-date information.

Brief Medical Information

Challenges your camper has

Please list any allergies or diet restrictions(medical)

Camp Choice

Select camp

*If registering for crew, please indicate which crew session*

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 agree to allow my child to be used in future Camp Columbia publications only

Any additional comments or questions

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 the parent or guardian of the child as listed above:

I understand that every effort will be made to contact me in case of a medical emergency. I hereby consent to having my child named on this form treated at a recognized hospital or local physician. I consent to over the counter medications, if necessary (eg. Tylenol), as approved by the Camp Nurse on site or by a local physician. To the best of my knowledge I have informed Camp Columbia of all details about this child's health and will contact camp regarding any changes before camp. I will COMPLETE THE HEALTH FORM and bring the form and medications with my child on registration day. I recognize that Camp Columbia will do its best to ensure a safe experience. I hereby release Camp Columbia, staff, the camp nurse, and all volunteers from any reponsibility and liability of any nature resulting from my child/self/ward's participation in any activity.

Welcome to Camp Columbia, we look forward to your visit!

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