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Windcrest Bible Camp Registration Form

Cheques can be made payable to:

Fundamental Baptist Church
885 Danells Dr
Saint John, NB
E2M 5A9

Please be sure to fill in all required fields. (Required fields are indicated by the * symbol.)

* First Name:

* Middle Initial:

* Last Name:

* Age:

* Address #1:

Address #2

* City:

* Province/State:

* Postal/Zip Code:

* Country:

Email:

* Grade Entering Into:

* I am Registering for:

* Father's Name:

* Mother's Name:

* Home Phone # (include area code):

* Emergency Phone #:

* Home Church:

* Pastor:

* Medicare #:

* Allergies:

* Medications:

Other Medical Info:

* Family Doctor:

* Doctor's Phone #: