SVSC Camper Application Form


We are excited to welcome you all back for our fourth year of South Van Sports Camp! It will be held from August 6 - 9 (8:30 am to 3:00 pm) at Immanuel Baptist Church. Kids ages 6 - 12 will be introduced to the fundamentals of a variety of sports while learning about core practical values according to the Bible.


Drop-off Location:

Immanuel Baptist Church - 109 E 40th Ave, Vancouver BC

Registration Fee:

$80.00 for one child, $40.00 for each additional sibling (registration fee must be paid in advance and includes SVSC T-shirt, lunch, and snacks for four days).

Please drop off or mail payment in full to Immanuel Baptist Church, 109 E 40th Ave, Vancouver, BC V5W 1L6 to guarantee your children's place at the camp.

 

Application Form:

Parent/Guardian 1 *
Parent/Guardian 1
Address *
Address
Phone *
Phone
Parent/Guardian 2
Parent/Guardian 2
Address
Address
Leave blank if duplicate.
Phone
Phone
Participant Information
Name *
Name
Date of Birth *
Date of Birth
Medical Form
Emergency Contact
Emergency Contact
If parent/guardian is away for the duration of the camp
Emergency Contact Phone
Emergency Contact Phone
Doctor's Name *
Doctor's Name
Doctor's Phone *
Doctor's Phone
Medical Equipment/Alerts
Please check all that apply:
I hereby release Immanuel Baptist Church, its board members, staff and sponsors, from responsibility and liability for any injury or illness that my son/daughter may sustain during activities. I understand that every effort will be made to contact the parents/guardians listed on this form in the event of an emergency. If I am unable to be contacted, I hereby authorize an adult leader of South Vancouver Sports Camp (Immanuel Baptist Church) to transport or arrange transportation of my named child to the nearest suitable medical facility. I authorize an adult leader of South Vancouver Sports Camp (Immanuel Baptist Church), as an agent for me, to consent to any x-ray examination; medical or dental treatment; and hospital care advised and supervised at a licensed facility under the laws of the province. I understand that I am financially responsible for any emergency medical and/or dental care given. I understand that certain information on this medical form may be shared with staff members in order to ensure the safety of my child.
By checking this box, I acknowledge that I have read and agree to the declaration stated above. *
I give permission for my child's picture and or video to be taken and used for promotional purposes and record keeping. *

Questions? Contact us at

southvansportscamp@gmail.com
604.445.9063
www.facebook.com/southvansports