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T-SHIRT SIZE
NAME
SURNAME
GRADE
CELL
DIETARY NEEDS
MEDICAL CONDITIONS
AND ALLERGIES
EMERGENCY CONTACT
NAME
CELL
CO
MP
LE
TE
& R
ET
UR
N W
ITH
FE
ES
IN
A M
AR
KE
D E
NV
ELO
PE
BY
14 J
UN
E
CAMPER
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DIVE GER
S M L XL XXL
YOUTH CAMPGR 8-12
GLEN MUIR2-4 JULY
GRADES
VENUE
DATE
COST
QUESTIONS?
PACK
8-12
Glen Muir Holiday Resort, Glen Eden
2-4th July
R550 including T-Shirt
Contact Mark on 043 735 2340
Comfortable clothes, walking shoes, bible and notebook,toiletries, towel, bedding, cutlery and crockery
Tue between 9-12am
Thur at 11am
CHECK IN
CHECK OUT
Whilst all reasonable precautions and measures will be taken, I understand that the attendance of
this camp and transport to and from this camp is undertaken at the above mentioned person’s own
risk and I indemnify, hold blameless and absolve the organisers, Stirling Baptist Church, and any of
the camp leadership, against any claims of whatsoever nature that may arise as a result of the above
mentioned person’s attending the above mentioned camp. I further request the leaders act ‘in loco
parentis’ during this camp. I understand that in the case of illness or accident, where medical
attention is required, I will be contacted as soon as possible and that the cost thereof will be my
liability.
INDEMNITY
I, the undersigned ................................................................................................ (guardianʼs name)
of ............................................................................................................................................... (address)
Contact (h) .................................................................. (c) ..................................................................
hereby consent that .............................................................................................................. (camper)
may attend the SBC Diverge Youth Camp, at Glen Muir Holiday Resort near
NO FORM WILL BE ACCEPTED WITHOUT A SIGNED INDEMNITY
Guardian ............................................................... Date ...............................................................
Glen Eden, from the 2-4 July 2019.
