Camper Registration Form 2022

CAMPER GENERAL INFORMATION

Name *

First

Last

Date of Birth *//

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

How did you hear about our Summer Music Camp?

AGREEMENTS

Permission for Camp Participation and Emergency Medical Treatment *

By filling in my name above, I hereby give permission to the camper named above to fully participate in Islington United Band Camp, held at 25 Burnhamthorpe Road, Toronto, ON. Participation will include physical activities both inside and outside of the church location, including at a field trip on the final day of camp, as well as photography and video for church purposes. I further grant permission to Islington United Church Music Camp or Church Staff to enlist emergency medical treatment if it is deemed necessary.

Date of Signing *

Release of Liability *

By filling in my name above, I agree to download, sign and submit on the first day of camp a Liability Release form. I understand that the camper named above will not be permitted to attend camp until this completed form has been received by Islington United Church.

Date of Signing *

CAMP FEES

A $50.00 non-refundable deposit is required to register for Music Camp. The deposit will be deducted from the balance of fees owing. The balance of $400/$450 is due on or before the first day of camp. Registrations are not considered complete until the deposit fee has been received. If Music Camp is canceled by Islington United Church due to unforeseen circumstances, your deposit fee will be refunded. We do not want finances to be a barrier to attending Music Camp. If you would like to be considered for a financial scholarship to offset the cost of camp, please contact Jason Locke (jason@islingtonunited.org; 416-239-1131 x 227) for more information.

Payment amount: *

Non-refundable deposit - $ 50.00
Early bird full fee - $ 450.00
Regular full fee (after July 1) - $ 500.00

Early bird and regular full fee amounts include the $50 deposit.

Payment type *

Credit card
E-transfer
Cheque

Credit Card

Card

Name on Card

E-Transfer

Send an email money transfer to office@islingtonunited.org. Include “Music Camp" and the camper's name in the message field.

Cheque

Mail or deliver a cheque payable to Islington United Church to Islington United Church, 25 Burnhamthorpe Road, Toronto, ON M9A 1G9. Note "Music Camp" and the camper's name in the memo field.

Camper Registration Form 2022

Islington United Church Music Camp

CAMPER GENERAL INFORMATION

CAMPER MUSICAL INFORMATION

PARENT/GUARDIAN INFORMATION

PICK UP AUTHORIZATION

CAMPER'S MEDICAL INFORMATION

AGREEMENTS

CAMP FEES

E-Transfer

Cheque

Camper Registration Form 2022

Islington United Church Music Camp

CAMPER GENERAL INFORMATION

CAMPER MUSICAL INFORMATION

PARENT/GUARDIAN INFORMATION

PICK UP AUTHORIZATION

CAMPER'S MEDICAL INFORMATION

AGREEMENTS

CAMP FEES

E-Transfer

Cheque

Share: