Tay Valley Bible Camp 2021
*Click on the name of the camp listed below to register online with an option to pay electronically*
Complete this entire form and mail with a $15.00 non-refundable registration fee, which will be applied to the total camp fee.
Name:____________________________________________ M__ F__ Date of birth __/__/____
Address:_______________________________ ______City___________________ Prov. _____
Postal Code:___________ E-mail address: ___________________________________________
Phone (H) ______________________ ______ Work/Cell:________________________________
Emergency Contact: _____________________________________________________________
Phone: _____________________________ Relationship: _______________________________
Med. #: _____________________________ Expiration Date: ___/___/______
Known Allergies: ________________________________________________________________
*ALL Medications must have clear written instructions, in original containers, and be turned in to the registrar upon arrival.
Please indicate if your child has a history of any of the following:
___ Diabetes ___ Bed Wetting ___ Sleepwalking ___ Asthma
___ Ear/Stomach Aches ___ Homesickness ___ Aggressiveness ___ A.D.H.D. ___ Other: _______________________
Please indicate which week you wish to attend:
Note: Register by June 1 for summer camp and receive $10.00 off total camp fees.
__ Young Adult Retreat (Online Registration) (Ages 18+) June 25 to 27 $50.00
__ Teen Ball Hockey Camp (Online Registration) (Ages 12-17) June 27 to July 2 $150.00
__ Junior Ball Hockey Camp (Online Registration) (Ages 7-11) June 30 to July 2 $75.00
__ Teen Adventure Camp (Online Registration) (Ages 13-17) July 4 to 9 $150.00
__ Teen Camp Week 2 (Online Registration) (Ages 13-17) July 11 to 16 $150.00
__ Teen Camps 1 and 2 (Online Registration) July 4 to 16 $250.00
*(Does not include weekend July 9-11)
__ Jr. Camp (Online Registration) (Ages 7 to 9) July 18 to 23 $150.00
__ Jr. Camp (Online Registration) (Ages 10 to 12) July 25 to 30 $150.00
__ Work Retreat (Online Registration) (Teens & Young Adults) August 1 to 5 $25.00
__ Pastors' & Leaders' Retreat (Online Registration) (Adults) August 17 to 19 Free
(Open to all pastors, associate pastors, Christian workers, youth pastors/leaders & wives)
__ Ladies' Creative Retreat (Online Registration) September 17 to 19 $50.00
Attention Returning Campers: Receive $10.00 off camp fee for each new camper you bring to camp. Also, teens can earn credits towards camp fees by helping on workdays (see website for details).
Complete an electronic registration form by clicking the name of the camp for which you wish to register. This will enable an electronic payment option. Or send the completed registration form with fees (Cheque or Money Order only) to:
Tay Valley Evangelistic Association, 115 Moss Ave. Fredericton, NB E3A 2G2
I, ___________________ will respect the rules and facilities of Tay Valley Bible Camp. Campers may be included in photos for promotional purposes, but names will not be revealed. I am aware that any unacceptable behavior may result in dismissal from camp without refund of fees.
*Permission is given for off site special activities for teen campers.
Signature: __________________________ Parent / Guardian: ___________________________
Please do not bring cell phones or other electronic devices to camp!