AKYSB BC - Camp Reflections, January 20

Join BC Post Secondary Students for a fun-filled weekend
at Evans Lake for Camp Reflections 2012!

Friday, January 20th, 2012 - Sunday, January 22nd, 2012

To register for Camp Reflection, download and sign the waiver form and fill out the information below.

Registration is $125

Registration includes: Transportation to Evans Lake, accommodations, food, and activities

You can pay for your tickets with a PayPal account or any major Credit Card through our secure payment site

Please download the Waiver form, print it out, sign it, and bring it with you to the retreat

Click here to download the Waiver form: Waiver Form

*asterix denotes required field

First Name:

Last Name:

Address:

City:

Postal Code:

Telephone number:

Email address:

University / College:

Gender

Date of Birth:

(YYYY/MM/DD)*

Care Card Number:

Medical History/Allergies:

Dietary Restrictions:

Requested Roommate:

Emergency Contact Information

First Name:

Last Name:

Relationship:

Home Number:

Mobile Number: