Victoria SDA - Kids Fun Summer Day Camp Registration 2023 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 8th to 11th Journey into Nature

Week 2:  Aug 14th to 18th Journey with Bible Heroes

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.

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

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Child Full Name
Please select the week you would like your child to attend
Gender
Child Home Address
Parent/Guardian Name
Emergency contact Name
when parent couldn’t be reached (parents or guardians are always contacted first)
Child have vision problem?
Take Medication?
Have Speech Problems?
Have Any Emotional Challenges?
Have Hearing Problems?
Have Any Physical Challenges?
Have Allergies?
Have Any Other Health Concerns?
Have any special dietary requirements?
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.
PARENT/GUARDIAN MEDICAL EMERGENCY CONSENT
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 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I understand that the names of my child/ren will not be published without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 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, 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
Program Fees: $100 per week per child. Special promotion, families with more than one child attending get the second week for free, or if your child invites a friend who has also registered, he or she must be registered by Aug 3, 2023.