JG25: Worthy • St James Turramurra

First Student (Early Bird) 0

First Name *

Last Name *

Gender *

Date of Birth *

School Year in 2025 *

Address

Street Address *

Suburb *

Postcode *

Contact Details

Student Email

Student Mobile Number

Home Phone

Dietary/Medical Info

Dietary requirements

Medical Information

Can paracetamol be administered on camp if necessary? *

Yes

No

Swimming Ability *

Medicare Card

Card Number *

Expiry *

Position on Card *

Health Plans

If the camper requires a plan or medication for an existing health condition (e.g. mental health plan, diabetes management plan, asthma etc.) please note the details below.

My child has special needs

Do you have a health plan that will need to be sent to camp directors? *

Parent/Guardian 1

Parent/Guardian Name *

Email *

Mobile Number *

Parent/Guardian 2

Parent/Guardian Name

Email

Mobile Number

All students that register & pay for camp before registrations close will also recieve a camp t-shirt. How good! Select your size in the drop down menu below:

T-Shirt Size *

Name of a buddy you would like to share a room with (if possible).

Name of your go to karaoke song you want added to a communal Spotify playlist

Permissions

BY SUBMITTING THIS FORM I CONSENT TO THE FOLLOWING TERMS:

In the event of accident or illness, I/we authorise the Elevate leaders to consent, where it is impracticable to communicate with me/us, to my/our children receiving any medical attention deemed necessary by a licensed physician and/or surgeon.

I/We also authorise the use of an ambulance service if, in the leaders' judgement, it is necessary.

I/We also authorize to engage such treatment and agree to pay the appropriate fees for such service and treatment.

I/We appreciate that every care will be taken by the leaders of the above-mentioned group and that the leaders and those connected with that group cannot be held responsible for personal injury, loss or theft of property affecting my children.

I/We agree to meet the expense of my/our children being returned home either by a staff person or by collecting him/her personally.

I/We understand that such an arrangement may be necessary on account of illness, injury, non-cooperation of any description on the part of my/our children or the inability of my/our children to meet the rigours and requirements of the activity, as deemed by the staff leader.

I/We understand there will/may be photographs and/or video footage taken of my children during this activity and am willing for my children to be so photographed or filmed in appropriate settings. I am also willing for these photos or this footage to be used to promote the ministry in a way that does not identify their name or details. My children are also willing for this to take place.

I/We understand that any cancellations after December 20 2024, will be non-refundable.

I/We have read and understood the information in the permission form pertaining to JG25: Worthy

Please contact Andrew at amarrett@stjamesturramurra.org.au if you have any questions or concerns.

I agree to terms and conditions for JG25: Worthy *

Yes

STANDING PERMISSIONS FOR OTHER ELEVATE ACTIVITIES THROUGH THE YEAR

General:

I/We give permission for my/our child to be administered paracetamol if necessary while participating in any future Elevate related events (e.g. Friday night youth).

Y/N *

I/We give permission for photographs/videos to be taken of my/our children during future Elevate activities (e.g. Friday night youth). I am also willing for these photos or this footage to be used to promote the ministry.

Y/N *

Name of Parent(s) Giving Consent *

Second Student (Early Bird) 0