To register and pay online using PayPal please fill out the form below. To pay by cash or cheque please Click Here

The cost is $10 per child. Registration is limited and will be filled in the order that applications are received. We still have space available.

Your Name *

Phone Number *

Your Email *

Childs Name *

Childs Age *

Address *

City *

Postal Code *

Child's Alberta Health Care # *

Allergies if any

Emergency Contact Person Name *

Emergency Contact Phone number *

Relation to Child *

Secondary Emergency Contact Person Name*

Secondary Emergency Contact Person Phone number*

Relation to Child *


By Selecting "I Agree" and submitting this form you agree that you are the legal parent or guardian of this child and that you give permission for this child to participate in the ALL DAY Option for Basketball and Music/Drama between camps on July 17-20, 2017. I understand that this program is run by Southwinds Church at Mahogany, and that the program is conducted by the church and its volunteers and staff. I am aware that my child is participating voluntarily and is doing so at his/her own risk and Southwinds Church at Mahogany, its members, agents, or volunteers, are not liable for any loss, damage, death, or injury, resulting from or in connection with such participation. I understand that my child's pictures will be taken but will not be used for promotional material either printed or online without parental consent. By submitting the above form to Southwinds Church at Mahogany, I accept the terms and conditions stated herein.

I Agree *

you will be automatically directed to PayPal for payment

* all fields marked with this are required to submit this form