Windsor 2016 Gurmat Camp

General Information

First Name*

Kaur/Singh*

Shirt Size*

D.O.B.*

Grade*

Health Information

Name of Physician

Physician Phone Number

Health Card Number

Any Allergies?*

enter N/A if none

Any Medication?*

enter N/A if none

Parent Information

Parent's Name*

Parent's Phone*

Parent's Email*

Address*

Street AddressCityState / Province / RegionZIP / Postal CodeCountry

Important Information

Please read below

• The above child is attending the Windsor Gurmat Camp 2016 with my consent at Gurdwara Khalsa Parkash Windsor located at 7955 CR-42, Windsor, Ontario N0R 1K0
• I am the parent/legal guardian of the above named child.
• My child will only be released to an authorized person listed on this form as parent/guardian or emergency contact.
• I hereby authorize the Camp authorities to consent to emergency medical treatment of the youth, if required.
• I am sending my child/ward to the camp with my full responsibility.

I would like to make following suggestion for the continuous betterment of the Windsor Sikh Youth Gurmat Camp.

Windsor 2016 Gurmat Camp