SOCCER CAMP REGISTRATION FORMChild's Name:_______________________________________________________________ Address:____________________________________________________________________ City:________________________________ P.C.___________________________ Phone Number:_____________________________________ Birthday:__________ BC Care Card #________________ Allergies or Medical Conditions:____________________________________________________ ____________________________________________________________ __________________________________________________________ Emergency Contact name & phone #:______________________________________________________ Church you attend (if any): ______________________ ___ Yes, our family will plan on attending the Soccer Sunday Wrap-up. Number attending:_____ I hereby grant my permission, as legal Parent/Guardian of the child mentioned above, to participate in the 2012 High Power Soccer Camp. In case of emergency, if reasonable efforts to contact me have failed, I hereby give church personnel the authority to act on my behalf to authorize medical treatment if necessary. I hereby release the church and its personnel from all claims for damages arising from any accidents or injuries caused by my child's participation. Name of Parent/Guardian:______________________ Signature:________________________________________ Date:_____________________________________________ Mail or drop off in mail slot at the front of the church before July 1, 2012 with a cheque for $25 per child - made out to Calvary Baptist Church After July 1, 2012 include a cheque for $35 per child. Calvary Baptist Church Soccer Camp
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