Fisher Bay Bible Camp - 2019 Application Form


Please fill out the information as best you can

Gender: 
Name: 
Street/Box: 
Town: 
Province: 
Postal Code: 
E-Mail: 
Phone #: 
Age: 
Birthday: 
Parent/Legal Guardian: 
Same Cabin As:
One Name Only
 
Camp To Attend: 
 
Skills
Archery - Wall Climbing - Camping - Riflery - Canoeing - Crafts - Sports

Note: Riflery is available to those 9 years old and over only.

Paintballing (add cost for paintballing only of $35)
Paintballing available only during Teen & Sr. Teen Weeks
 
Medical Number: 
Personal Number: 
Last Tetanus (if any): 
 
Are there any medical problems we should know about?
Allergies Asthma Bed Wetting
Epilepsy Diabetes Sleep Walking
 
If yes, please explain: 
 
Do we have your permission to authorize medical treatment by a doctor?: 
 
In case of emergency, Please list one person, other then parent, to be contacted:
Name: 
Home Phone: 
Work Phone: 
 
Please write the names of people who can visit or pick up your child from camp: 
 
Have you read the waiver and terms of enrollment on the brochure, and are you in agreement with them? *: