3 Day Pass: $50.00 until July 31st 2009,
$60.00 after July 31st, 2009.
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Which includes all my meals, camping and admission
to the entire event |
*Name: |
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Full Address: |
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Birthdate: |
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Phone: |
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Cell: |
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*Email: |
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Name of Parish: |
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School: |
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Status: |
Youth |
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Adult |
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Volunteer |
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CORC / YAC / CCoT |
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Priest |
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Deacon |
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Seminarian |
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Religious |
| In Case of Emergency Contact: |
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*Name: |
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Full Address: |
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Relationship to Applicant : |
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Phone : |
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Family Physician : |
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Physician Phone Number : |
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OHIP Number : |
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Please list any Allergies
and / or Medical Conditions : |
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In the case of an emergency, I understand that when feasible, every effort will be made to reach the
guardian/parent or the emergency contacts on this form but in the event that one cannot be reached
I hereby give permission to secure medial treatment as deemed necessary. I understand that all
reasonable safety precautions will be taken at all times by the Diocese of Peterborough, its staff and
volunteers during this event and activities. I understand that there is a possibility of unforeseen
hazards and know the inherent possibility of risks. I agree to not hold the Diocese of Peterborough,
its leaders, employees and volunteer staff liable for damages, losses, diseases or injuries incurred by
the subject of this form.
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| Parent / Guardian: I agree to the above statement
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| Participant: I agree to the above statement
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| |
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| Statement of Consent |
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I hereby give permission for images of myself or my child, captured during regular and special activities
leading up to and including SONfest 2010 through video, photo, and digital camera, to be used solely for
the purposes of the promotional materials and publications and waive any rights to compensation or
ownership thereto
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Participant: I agree to the above stated considerations and conditions
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Parent / Guardian if registrant is under 18 : I agree to the above stated
considerations and conditions
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With Online registration: Please send your cheque payable to RCEC-SONfest 2010
(or drop off cash) to:
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VEYO Centre
820 Frank Street
Peterborough, Ontario
K9J 4N4
Confirmation of Registration and Activity sign up forms
will be emailed to you prior to SONfest '10
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| |
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