Application for teen camp

Thank you for your interest in teen camp. Please complete the application form below and we will contact you in due course confirm your acceptance. You must complete all fields in the application form.

First Name:
*
Last Name:
*
Male / Female:
*
Church / Congregation:
*
Date of birth (dd/mm/yy):
*
Email Address:
*
Mobile Phone number:
*
Address:
*
City:
*
Postcode:
*
Will you need to use the coach travelling from Central London or are you making your own way to camp?:
*
Please list any special dietary requirements allergies illness or disability details that we need to be aware of (if none please write n/a):
*
If you are under the age of 18 we need to have parental consent. Please complete their details in the box below. If you are 18 or over please write n/a in the box below.
Parents name(s) and contact details. Please provide mobile phone numbers and email:
*
Please answer in 100 words or less ?What is your favourite passage in the book of John and why?' and ?Why do you want to come to camp?' :
*
WAIVER & CONSENT: In an emergency and/or if I cannot be contacted I am willing for my child to receive necessary hospital or dental treatment including an anaesthetic. I understand that while at camp and involved in camp activities my child will be under the authority supervision and care of designated adults approved by the director of youth and children's ministry. I also understand that while those designated adults will take reasonable care of my child they cannot necessarily be held responsible for any loss damage or injury suffered by my child during or as a result of activity. Please bear in mind that the church or her agents cannot be held responsible for any loss or damage to personal property that you are bringing to camp. I have read the waiver & consent and I agree to it's terms. Please check box

Yes
No
Mailing list signup:

Check this box to signup for our site mailing list.
Security code:
*
Do not enter anything in this field:

* indicates a required field