Summer Camp - MarioESP

Victoria SDA - Kids Fun Summer Day Camp Gallery 2023

Victoria SDA - Kids Fun Summer Day Camp 2024 Registration Form

Organized by: Victoria SDA Church – Children Ministries

Venue: Lakeview Christian School, at 729 Cordova Bay Rd, Victoria BC, V8Y-1P7

Time: 9 AM to 3 PM

Week 1: Aug 12^th to 16^th

Week 2: Aug 19^th to 23^th

Ages: 5-12

Price: $100 Price per Child per Week

Activities: Sports- Drama class- Arts & Crafts – VBS – Games – Field trips and more.

Parents and/or Guardians, please complete all the pages of the registration form. A separate registration form MUST be filled out for EACH child attending. All information is required to complete the registration process.

Summer Camp Flyer

Clear Form

If you would like to print the form and hand it in the first day you can get the form here.

Summer Camp Form

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Child Full Name *

First

Last

Please select the week you would like your child to attend *

Week 1: Aug 12th to 16th
Week 2: Aug 19th to 23th

Child Date of Birth *

Age *

Gender *

Male
Female

Home Address *

Child Home Address

BC Care Card # *

Family Doctor

Family Doctor #

Parent/Guardian Name *

First

Last

Relationship to Child

Parent/Guardian Email *

Parent/Guardian Home Phone #

Parent/Guardian CellPhone #

Parent/Guardian Place of Work Phone #

Emergency contact Name

First

Last

when parent couldn’t be reached (parents or guardians are always contacted first)

Relationship to Child

Emergency contact Phone #

Child have vision problem? *

Take Medication? *

Have Speech Problems? *

Have Any Emotional Challenges? *

If Yes Please Specify

Have Hearing Problems? *

Have Any Physical Challenges? *

Have Allergies? *

Have Any Other Health Concerns? *

If Yes Please Specify

Have any special dietary requirements? *

Name

PICK-UP AUTHORIZATION: Parents/Guardians and Emergency Contacts are already authorized to pick the child up from the program. Please list any other person(s) who may be picking up your child.

Relationship to Child

Phone #

PARENT/GUARDIAN MEDICAL EMERGENCY CONSENT *

I agree and give my permission

I, in the event that my child is injured, ill or is in need of medical attention, I authorize the Victoria Seventh-day Adventist Church Kids Fun Summer Day Camp staff and/or leader or agents to seek medical attention and/or admit my child to hospital if I am unable to be contacted or am otherwise unable to respond. I authorize in the event of an emergency, my child to be transported by the designated leaders or drivers or arrange for transport by ambulance to the nearest suitable medical or hospital facility when injury is not treatable at the scene. I also authorize my child to be medically treated as determined appropriate by Kid’s Fun summer day camp staff/Leaders. I agree that any cost incurred for such services shall be my responsibility.

Photo/Media Consent

I agree and give my permission

I give permission that photographs, and videos of my child(ren) taken during the program can be used for in-house purposes within the Victoria Seventh-day Adventist Church Kid’s Fun Summer Day Camp homepage, Facebook page and Future Summer Day camp flyers.
I understand that the names of my child/ren will not be published without
my written permission.

Field Trip Consent

I agree and give my permission

I hereby give permission for my child, to participate in organized field trips under the leadership and supervision of the Kid’s Fun Summer Day Camp Leaders. I understand that the Victoria Seventh-day Adventist Church will use approved mode of transportation and that she/he will not be seated in unapproved child safety seat. I understand that notices (when, where, time of return, contact phone #) will be posted on the doors of the Lakeview Christian School’s Gymnasium anytime the Summer Day Camp initiates a Field Trip. (If this form is not signed and dated, a separate permission form will have to be provided for each field trip).
I understand that the names of my child/ren will not be published without
my written permission.

STATEMENT OF ACKNOWLEDGEMENT *

I agree and give my permission

I, have read and understood the Victoria Seventh-day Adventist Kids Fun Summer Day Camp 2023 Program and have completed, in full the
registration form. I state that the information provided in the registration is accurate and to my best knowledge.
Your child will be involved in several activities as part of this program. These activities may include, but are not limited to, walking, running, swimming, field trips and other sports and games. While all programs are supervised by trained staff who instruct participants in safety, your child may still get injured, or your child’s property may be damaged, because of participating in the program.
Knowing and understanding the program, activities and risks, you agree to allow the participation of your child in the Summer Day Camp program.

Payments Option *

Cheque (Please write your checks to: Victoria Seventh-day Adventist Church)
E-Transfer to giving@churchinvictoria.org. However, it is very important for parents to remember that they should include their information in the memo notes in order for us to be able to identify the purpose of the transfer.
Credit or debit cards. As for card payments, using the POS terminals, we can also accept card payments, on-site on the first day of camp.
Cash, bring your cash on the first day of the summer camp