This form is for registering for the Dauphin Bible Camp Summer Camps. Please visit the menu for other camps. Online payment is only accepted through PayPal.

Name (*)

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Address (*)

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City (*)

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Province (*)

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Postal Code (*)

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Birthdate (*)

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Gender (*)
Male Female
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Phone Number (*)

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Emergency Number

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email (*)

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Father

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Mother

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Camp Information

Select Camp (*)
Special Needs-June 14-19Young Campers-July 1-3Junior Camp-July 4-9Golf Camp-July 4-9CLT Program-July 4-23Junior Camp-July 11-16Camp Diakonos-July 11-23Junior Camp-July 18-23Teen Camp-July 25-30Horse Camp-July 25-30Media Camp-August 3-6Young Campers-August 4-6Junior Camp-August 8-13Camp Diakonos-August 8-20Junior Camp-August 15-20Teen Camp-August 22-27Teen Retreat-September 17-19
Please select a camp. Please select the camp you would like to attend. You will have to select your payment option for this camp at the bottom of this form.
I would like to recieve my confirmation by (*)
emailmail
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Subscribe to our newsletter
Subscribe
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Cabin Mate

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Skills
BMX
Drama
Card Making
Horsemanship
Archery
Journalism
Sports
Nature Lore
Swimming
Riflery

Invalid Input Please check 4 skills.

Medical Information

Medical Number

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Allergies

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Other Health problems

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Physicians name

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Date of last tetanus shot

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Physicians Phone

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By checking this box I agree to the following: (*)
To the best of my knowledge my child is in good health. I will notify the camp if my child is exposed to an infectious disease during the three weeks prior to camp. In the case of an emergency, contact me. In the event that I cannot be reached, I give permission to the physician selected by the Camp Director to hospitalize, secure treatment, order injections, anesthesia or surgery for my child as named above. I give permission for the Camp Director to authorize the Camp Health Officer to administer over the counter medications to my son/daughter. I accept financial responsibility for the costs incurred in excess of the benefits allowed by provincial health and/or personal medical insurance. I agree to allow photographs or video of camp activities, which may include the child in my care, to be used in camp promotional material or brochures. I agree to allow Dauphin Bible Camp to share personal information (name/ address) with churches affiliated with Dauphin Bible Camp and CSSM Ministries.
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Select Products (*)
DBC 2010 T-Shirt - 12.00 CAD
DBC 2010 Hoodie - 40.00 CAD
Part Registration Fee - 50.00 CAD
Full Young Campers Registration Fee - 95.00 CAD
Full Media Camp Registration Fee - 155.00 CAD
Full CLT/Diakonos Registration Fee - 155.00 CAD
Full Junior Camp Registration Fee - 200.00 CAD
Full Teen/Horse Camp Registration Fee - 205.00 CAD
Full Special Needs Registration Fee - 265.00 CAD
Full Golf Camp Registration Fee - 265.00 CAD
Full Teen Retreat Registration Fee - 80.00 CAD

Invalid Input *Please select the camps/products that you would like.

Total Due
0.00 CAD

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After you click submit you will be taken to the PayPal website where you can enter your payment information and complete your registration. You do not need to have a PayPal account to use PayPal just select the pay with credit card option.