Unite Camp 24-28Sep • Mitchelton Presbyterian Church

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Attendee Details

Registration Type *

Camper

Leader

First Name *

Last Name *

Preferred Name

Gender *

Phone Number

School *

Church *

Other Church *

Date of Birth *

Email Address

School Grade *

Address

Home Address *

Home Suburb *

Home Postcode *

Home Address Line 2

Home State *

Parent/Guardian Details

Parent First Name *

Parent Email *

Parent Phone *

Parent Last Name *

Parent Confirm Email *

Emergency Contact Information

Emergency Contact 1

Emergency Contact 1 First Name *

Emergency Contact 1 Relationship *

Emergency Contact 1 Last Name *

Emergency Contact 1 Phone *

Emergency Contact 2

Emergency Contact 2 First Name *

Emergency Contact 2 Relationship *

Emergency Contact 2 Last Name *

Emergency Contact 2 Phone *

Dietary Requirements

Nature Of Dietary Requirement *

Lifestyle

Mild/Moderate - CAN tolerate traces

Serious / Anaphylactic - CANNOT tolerate traces

Tip: If more than one applies, please select the highest option and provide details below.

Dietary Requirement Details *

Tip: Provide additional details for dietary requirements

Other Information

Other Information Detail

Tip: Please provide further information about any box ticked above.

Swimming Ability *

Restricted Activities

Tip: Are there any activities that your child is restricted from participating in?

Photography Approved for the Child *

Music

Tip: Are you able to help with music on camp? List how you can help.

Anything else?

Tip: Is there anything else you'd like to let us know that would help the attendee to have a great camp.

Leader Information

Blue Card Number *

Blue Card Expiry *

Blue Card Type *

Bluecard Name *

Tip: Name as it appears on blue card

Pressafe Training Up to date

Yes

Tip: Have you completed PresSafe training and is it up to date?

CPR

Yes

Tip: Do you have current CPR qualifications

First Aid

Yes

Tip: Do you have current First Aid qualifications

Ways I can help

Tip: Please list any skills/passions you have that can help us for running camp (Eg. music, running games, etc)

Important Information

You acknowledge & agree with the following:
1. Privacy:
Protecting your privacy is important to us. The information we seek allows us to manage risk, provide reasonable care and administer involvement in our program. We will not disclose personal information to any third party, unless compelled by law, but provide it only to those who are acting on behalf of the Presbyterian Church of Queensland who need it to enable them to perform their approved activities (e.g. Camp Director, First Aid officer).

I understand the details given herein will be used by leaders to contact myself and/or my child/ren and that the details will not be given to any third party, except as provided above.

2. Medical:
You also acknowledge that while the Presbyterian Church of Queensland and its agents will make every reasonable effort to minimise exposure to known risks, every hazard associated with activities cannot be foreseen or may be beyond the control of the Presbyterian Church of Queensland and its agents. In the event of any emergency where your nominated contact people are unavailable, you authorise the Presbyterian Church of Queensland and its agents to obtain medical advice and/or assistance which they deem necessary. You further authorise qualified practitioners to administer anaesthetic if required. You accept all operation, blood transfusion and/or anaesthetic risks involved in the event that such procedures are deemed necessary. You accept the responsibility for payment and agree to pay medical, transport and any other related expenses. You confirm that the information contained in this online registration is true and correct. You agree to inform the Camp Director of any change to these details. You are welcome to contact our office (07 3106 3266) in relation to issues regarding your personal information and for a copy of our Privacy Policy.

3. Refund Policy: You acknowledge that, due to financial commitments made prior to the camps, we will not refund camp fees unless the attendee is withdrawn 14 days prior to the camp commencement date. Any refund will incur an administration cost.

4. Camp Arrival / Departure: We expect that campers signed up for camp will be there for the entire duration of the camp. We understand that situations that arise and there will be times when campers need to leave camp early. We won't have facility to accomodate late check-ins or early checkouts outside of emergencies.

5. Travel In Car
I authorise our child/ren to travel in a car driven by an approved leader or an approved parent, unless we explicitly advise the leadership team otherwise. (Your children will not be in a vehicle driven by a learner licence holder.)

6. Authorisations and Expectations

By completing this form, I hereby give permission for my child/ren to attend camp and to participate in all scheduled activities, unless we explicitly advise the leadership team otherwise. In doing so I undertake to provide the leaders with any information relevant to the wellbeing of my child/ren prior to them attending camp.

I also acknowledge that being part of a community involves mutual care and consideration, and therefore agree that unacceptable behaviour may result in my child/ren being sent home or being prohibited from participating in activties while on camp.

Date