Southside Presbyterian Church - YOUNG Adults camp

moogerah sunrise .jpg — YOUNG ADULTS

Camp 2024

camp information

Cost: $30 for the cost of food (Eftpos available) (IF money is an issue, please chat to Ben about this!)

Arrive: Some of us will leave from church at 6pm Friday and have maccas on the way. If you can't make it then, come anytime on Friday night.

Location: We're out at Lake Moogerah. Sam will send the address out later.

General activities: Word, prayer, community, all the good stuff.

Depart: We'll finish up after lunch on Sunday

Southside YouNG ADULTS Camp Registration Form

Name

First Name

Last Name

Date of Birth

Address (Street, Suburb, Postcode)

Special Dietry Requirements

Do you have any special dietary requirements? If so, please list them

Medical/Psychological Conditions or Allergies

Are there any medical or psychological conditions which require special attention that we should know about e.g. diabetes, asthma, allergy to bee-sting, other allergies that may affect you including food allergies, hearing or sight impairment, ADHD, behaviour issues, formal counselling situations, or any other? Please list below:

Medical Information

Please Give details of your medical insurance if applicable

Medicare Details

Medicare Number | Number of People on Medicare Card | Expiry Date

Have you previously broken/fractured any bones?

That relate to camp - If yes, please give details

Can you swim?

Yes - Fair Swimmer

Yes - Good Swimmer

Emergency Contact Details

In the case of an emergency, please list the phone numbers where you and another trusted adult may be contacted during the course of the program.

I approve photos of me being used appropriately for advertising (eg. Southside Facebook page)

Yes

Your Agreement With Us

I am aware, in signing this document regarding my participation this program, that certain elements of the program could be physically and emotionally demanding. Furthermore, I understand that certain inherent risks and dangers may exist in the activities in which I will be participating. I acknowledge that while the organisation and its leaders will make every reasonable effort to minimise exposure to known risks, all hazards and dangers associated with these activities cannot be foreseen or may be beyond the control of the organisation, its leaders and staff. In the event of any emergency where my nominated contact people are unavailable: 1. I authorise the leaders to obtain medical advice and/or assistance which they deem necessary. 2. I further authorise qualified practitioners to administer anaesthetic if required. 3. I accept all operation, blood transfusion and/or anaesthetic risks involved in the event that such procedures are deemed necessary. 4. I accept the responsibility for payment and agree to pay medical, transport and any other related expenses. 5. I confirm that the information contained in this application is true and correct. 6. I agree to inform the leader of any change to these details.