Wilderness Skills Girls (Ages 10-12) - Individual Registration

Please enter information in the form below to process registration for event Wilderness Skills Girls (Ages 10-12).

First Name *

Last Name *

Address *

City *

Phone *

Email *

Camper first name *

Camper last name *

Date of birth *

Postal Code *

Have you ever been to CBBC? *

Yes

Cabin mate request (one name only) *

Medical History

Does the camper have any known allergies? If yes, please list them.

Does the camper take any daily medications? If yes, please list them.

Health card number *

Health card expiration date *

Emergency Contact

Emergency contact full name *

Emergency contact phone number *

Additional Donations

Would you like to make an additional donation to CBBC?

Yes

Where would you like your donation to go?

General camp

Keep a camper

Renovation fund

It doesn't matter to me

How much would you like to donate?

I would like to subscribe to the Cape Breton Bible Camp newsletter

This is the _ child I am registering *

If you would like to apply for financial assistance please fill out the form at the link below:
Keep A Camper Form

I agree to allow photographs *

Yes, I agree to allow photographs or video of camp activities, which may include my child, to be used in any and all camp promotional material including the sharing of photographs and videos with ministry partners of One Hope Canada.

No, please don't use my child's photo for any promotional materials for any reason.

Payment Information

Would you like to apply for our Keep a Camper program? *

Yes

Coupon

Amount

Discount Amount

Gross Amount

Deposit Required (Non-Refundable)

Payment Type

Payment Method

Credit Card

Credit or debit card*