Victory Retreat Center Camper Registration
VICTORY RETREAT CENTER
ONLINE REGISTRATION
  Applicant's Name:   
  Age:              Male          Female
  Have you read the Code of Conduct?      Yes          No
  Applicant's Date of Birth:    
  Applicant's School Level:    
  Has Applicant Attended
  VBC Before?		   Yes          No
  Parent/Guardian Name:    
  Address:   
  City:   
  Province/State:   
  Postal Code:   
  Home Phone:   
  Work Phone:   
  Name of Pick-up Person:    
  Name of Church:    
  Name of Pastor:    
  Medicare Number:   
  Email:   
  Does Applicant Take Medication?      Yes          No


  If presently taking medication
  please explain.


  



Please choose the event below that you are registering for. For dates, times and registration fees please click on the event name.


Winter Youth Retreat
Summer Children's Camp
Summer Teen Camp
Family Camp


Thank You!
                       

 

 

 

Victory Retreat Center
821 Chemin de la Carriere, Opposite Half Moon Lake Road #3
Brownsburg, QC J8G 1K7
1-450-533-9161
Content copyright © 2010 Victory Retreat Center
All rights reserved.