EmailMeForm
Day Camp Registration Form
Register your camper for our Summer Day Camp.
JULY 24 - 28 / 9 AM - 4 PM
Fort Saskatchewan Alliance Church
Camper's Name
*
First
Last
Does the camper have any known allergies?
*
Yes
No
Age Group (the grade they are currently enrolled in 2022/2023):
*
Please select
kindergaten
Grades 1
Grade 2
Grade 3
Grade 4
Grade 5
Grade 6
Please specify
Desired Club (first choice). They will choose their clubs later with more options.
*
Soccer
Football
Volleyball
Basketball
Painting
Choir
Drama
Dance
Cooking Class
Crafts
Community Service
Other
Emergency Contact Information
Please enter the name of the parent or guardian who should be contacted in the case of an emergency.
Name
*
First
Last
Relationship
*
Please select
Parent
Grandparent
Legal guardian
Sibling
Relative
Friend
Phone
*
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###
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Email
*
Address
*
Street Address
Address Line 2
City
State / Province / Region
Postal / Zip Code
Antigua and Barbuda
Aruba
Bahamas
Barbados
Belize
Canada
Cayman Islands
Cook Islands
Costa Rica
Cuba
Dominica
Dominican Republic
El Salvador
Grenada
Guatemala
Haiti
Honduras
Jamaica
Mexico
Netherlands Antilles
Nicaragua
Panama
Puerto Rico
Saint Kitts and Nevis
Saint Lucia
Saint Vincent and the Grenadines
Trinidad and Tobago
United States
Argentina
Bolivia
Brazil
Chile
Colombia
Ecuador
Guyana
Paraguay
Peru
Suriname
Uruguay
Venezuela
Albania
Andorra
Armenia
Austria
Azerbaijan
Belarus
Belgium
Bosnia and Herzegovina
Bulgaria
Croatia
Cyprus
Czech Republic
Denmark
Estonia
Faroe Islands
Finland
France
Georgia
Germany
Greece
Hungary
Iceland
Ireland
Italy
Kosovo
Latvia
Liechtenstein
Lithuania
Luxembourg
Macedonia
Malta
Moldova
Monaco
Montenegro
Netherlands
Norway
Poland
Portugal
Romania
San Marino
Serbia
Slovakia
Slovenia
Spain
Sweden
Switzerland
Ukraine
United Kingdom
Vatican City
Afghanistan
Bahrain
Bangladesh
Bhutan
Brunei Darussalam
Myanmar
Cambodia
China
East Timor
Hong Kong
India
Indonesia
Iran
Iraq
Israel
Japan
Jordan
Kazakhstan
North Korea
South Korea
Kuwait
Kyrgyzstan
Laos
Lebanon
Malaysia
Maldives
Mongolia
Nepal
Oman
Pakistan
Palestine
Philippines
Qatar
Russia
Saudi Arabia
Singapore
Sri Lanka
Syria
Taiwan
Tajikistan
Thailand
Turkey
Turkmenistan
United Arab Emirates
Uzbekistan
Vietnam
Yemen
Australia
Fiji
Kiribati
Marshall Islands
Micronesia
Nauru
New Zealand
Palau
Papua New Guinea
Samoa
Solomon Islands
Tonga
Tuvalu
Vanuatu
Algeria
Angola
Benin
Botswana
Burkina Faso
Burundi
Cameroon
Cape Verde
Central African Republic
Chad
Comoros
Democratic Republic of the Congo
Republic of the Congo
Djibouti
Egypt
Equatorial Guinea
Eritrea
Ethiopia
Gabon
Gambia
Ghana
Gibraltar
Guinea
Guinea-Bissau
Cote d'Ivoire
Kenya
Lesotho
Liberia
Libya
Madagascar
Malawi
Mali
Mauritania
Mauritius
Morocco
Mozambique
Namibia
Niger
Nigeria
Rwanda
Sao Tome and Principe
Senegal
Seychelles
Sierra Leone
Somalia
South Africa
Sudan
Swaziland
United Republic of Tanzania
Togo
Tunisia
Uganda
Zambia
Zimbabwe
Country / Region
Day Camp Registration Fee:
*May 1st - June 25: (20% OFF)
$60.00
*June 26 - July 24:
$75.00
Payment can be made by Interac E-transfer giving@fortsaskalliance.com (make a note it’s for DAY CAMP and your child’s name) or debit payment at the church -Scholarships are available; please e-mail Pastor Carlos at csantos@fortsaskalliance.com
*
I UNDERSTAND
Participation Waiver
I, the above named parent/guardian, give my voluntary consent for the above named student to participate in activities in association with Fort Saskatchewan Alliance Church. I release Fort Saskatchewan Alliance Church, it's Elders Board, staff, volunteers and agents from any loss, personal injury, accident misfortune or damage to the above named student or his/her property, with the understanding that reasonable precautions shall be taken to ensure the health and safety of the above named. I understand that Fort Saskatchewan Alliance Church, its staff, volunteers or agents reserve the right to dismiss a participant who is in their opinion a hazard to the safety and wellbeing of others, who appears to have rejected the reasonable guidelines of the activity.
If you accept and agree with the terms and conditions stated above please click "I AGREE."
*
I AGREE
Medical Waiver
Furthermore, I authorize Fort Saskatchewan Alliance Church staff or volunteers to approve and obtain any and all medical attention if deemed necessary; with the understanding that all reasonable attempts have been made to consult with myself beforehand except in the case of minor illness and/or first aid where deemed appropriate. Furthermore, I release Fort Saskatchewan Alliance Church, it's Elders Board, staff, volunteers and agents from any loss, personal injury, accident misfortune or damage to the above named student or his/her property, with the understanding that reasonable precautions shall be taken to ensure the health and safety of the above named. I understand that Fort Saskatchewan Alliance Church, its staff, volunteers or agents reserve the right to dismiss a participant who is in their opinion a hazard to the safety and wellbeing of others, who appears to have rejected the reasonable guidelines of the activity.
If you accept and agree with the terms and conditions stated above please click "I AGREE."
*
I AGREE
Alberta Health Care Card #
Photography Release
I, the above named parent/guardian, give permission for the above named student to have his/her photograph taken or to be video recorded and understand that it may be used in the following ways: motion picture video, slide shows or still images shown at Fort Saskatchewan Alliance Church during public services or community events, posted to the church website, public church or Youth specific Facebook or Instagram page, or printed for bulletins, posters, invitations or other promotional material.
I understand that by clicking "I AGREE" that I am consenting to my child's photograph or video recording being used in the above stated ways and the risks associated with that. I hereby release Fort Saskatchewan Alliance, its Elders Board, staff, volunteers and agents from any consequences that may occur from the above stated activity.
*
I AGREE
Signature
*
Clear