Secret Signup Page For Campers

Hey, this form is for those who may be a little bit late signing up for the weekend… Please don’t share this page with anyone, thanks 😃

    Camper Details

    First Name

    Last Name

    Date of Birth

    Church

    Campers Address

    Address Line 1

    Address Line 2

    City

    Postcode

    Booker Details

    First Name

    Last Name

    Telephone Number

    Email Address

    Emergancy Contact

    First Name

    Last Name

    Telephone Number

    Medical Details

    Is medication required? If so, please state type & dosage

    Please describe medication required

    Does this camper have any aditional care needs?

    Please describe additional care needs

    Does this camper have any alergies

    Please describe alergies

    Does this camper have any dietary requirements?

    Please describe dietary requirements

    Doctor Details

    Doctor Name

    Doctor Phone Number

    Doctors Address

    Address Line 1

    Address Line 2

    City

    Postcode

    Sleeping Arrangements

    Please list the names of those you wish to share a room with below. (Subject to behaviour and room avilability)

    Photo Consent

    During this weekend we will take photos and videos. The photos/videos may be used on social media, on this website and may be displayed during church services or groups.

    Please select whether you do or do not want photo's of your child to be taken

    Campers Agreement

    Campers must read the below campers agreement, and confirm that they agree with it.
    1. During the sessions there will be time spent looking at the Bible and in praise and worship. You are expected to respect this time and not disrupt it for others.
    2. Aggressive and offensive behaviour or language will not be tolerated.
    3. You are expected to respect each other, the leaders, other people’s property and the site itself. Therefore, boys and girls will not enter each other’s accommodation, and any damages should be reported to a leader.
    4. Alcohol, illegal drugs, offensive weapons and tobacco are not permitted at Camp.
    5. If you choose to bring a mobile phone, iPod, or any other electronic device it is your own responsibility and if used inappropriately, may be confiscated.

    Parent / Carer


    Parents must read below, and confirm that they agree with it.

    I give permission for my child to attend the Ebby Youth Groups Weekend Away on 21st-23rd October 2022 and agree to the following:
    1. For my child to receive first aid treatment by the dedicated staff.
    2. In an emergency, for necessary medical treatment to be administered to my child at the nearest hospital if I cannot be contacted.

    Data

    I agree that by submitting this form my data will be processed in accordance to Ebenezer Chapel's Data Policy, a copy of which can be found at EbenezerChapel.org.uk/Policies.