Summer Sikhi Camp Information

Your Details

Please fill out a seperate form for each person attending camp.

Your Name *

First

Last

Telephone Number *

Email *

Are you filling this form out for yourself or for your child? *

Childs Name *

First

Last

Age

Next of Kin/ Emergency Contacts

At least two emergency contacts should be provided

Emergency Contact 1 Name *

First

Last

Relationship *

Phone *

Emergency Contact 2 Name *

First

Last

Relationship *

Phone *

Medical Declaration

PLEASE FILL OUT ALL DETAILS BELOW - WRITE "NONE" if not applicable

Please give details of any Known Medical Conditions/ Allergies / Sensitivities / Special Needs and details of any known precautions or remedies (e.g. Penicillin, Food Colourings, Travel Sickness, Bed-wetting, etc.) *

If your child is currently taking regular medication please give FULL details below: *

Is there any other medial information you feel would be helpful for us to know? *

GP Name *

First

Last

GP Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

GP Telephone *

Click To Download:

Please fill out:

Your Details

Next of Kin/ Emergency Contacts

Medical Declaration

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