Missfits - Sports Camp Registration 2017
Personal Details
Name*
First Name Last Name
Gender*
Male Female
Date of Birth*
Day Month Year
Shirt Size*
Address
Street Address
Street Address Line 2
City State / Province
Postal / Zip Code
Church (If Applicable)
Cellphone Number
Area Code Phone Number
Contact E-mail*
Been before?
Yes No
Preferred Sports
Sport #1*
Sport #2*
Sport #3
Sporting Achievements
Brag about how good you are:
Emergency Contact Details
Name of Emergency Contact*
Must be available 24 hours a day during the camp
Relationship to you*
Phone Number
Area Code Phone Number
Work Phone
Cell Phone*
Medical Details
Specify any conditions that may effect you during camp and require special care:
Medical conditions
Medication - Specify any medication that you may be taking during camp:
Are you allowed to be administered Paracetamol?*
Yes No
Last tetanus shot Date:
Dietary
Dietary Requirements - vegetarian, dairy-free, nut-free, gluten-free, other food allergies etc:
Bus Service and Time
Should be Empty:

Preferred Sports

Sporting Achievements