College and Careers Camp 2015

Those Attending Camp*

$50 - Individual$90 - Couple$90 - Couple with Babies or Toddlers

Number attending*

First Family Member*

First NameLast Name

Second Family Member

First NameLast Name

List names of Babies and Toddlers (optional)

E-mail*

Phone Number*

Area CodePhone Number

Address*

Street Address

Street Address Line 2

CityProvince

Postal CodeCountry

Any other Information we should know.

While every precaution is taken for the safety and good health, some sports and activities carry with them the inherent risk of personal injury beyond the risks associated with many of the recreational activities at Ontario Christian Assembly Inc.

I/we understand and accept these risks and agree that by participating in those activities, I/we may be taking part in a recreational activity that presents the potential for personal injury.

I/we, represented by the electronic signature below, undertake and agree to indemnify and hold harmless Ministry Personnel, Ontario Christian Assembly Inc., its Deans and Board of Directors from and against any loss, damage or injury suffered by the participant as a result of being part of the activities of Ontario Christian Assembly Inc., as well as of any medical treatment authorized by the supervising individuals representing the Camp.

Electronic Signature (Initials please, if submitting electronically)*

Payments are processed through PayPal. You may pay using an existing PayPal account, or any major credit card / debit card. You may also mail a cheque to:

OCA

PO Box 194

Selkirk, On N0A 1P0

Your Email Address to send conformation to:*

Payment Options*

Mail Cheque to OCA (at above address)PayPal (PayPal account, Visa or MC)Other Method

College & Career Camp Registration