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AMUC
Cheers Family Camp
Register for AMUC 2022!
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Working With Children Card
Some of the agencies we will be visiting require a current WWCC for entry. Please upload a photo or copy of your current WWCC here
Note: if you do not have a current WWCC, please apply for a card and send the receipt to SU WA
Max. file size: 248 MB.
CHEERS Camp 2021 Participant Details
Number of Adults (16+)
*
Adult (16+) Details
*
First Name
Surname
DOB
Contact Number
Email
Number of Children 13-15yrs
*
Number of Children 6-12yrs
*
Number of Children 2-5yrs
*
Number of Children under 2yrs
*
Child Details
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Surname
DOB
Postal Address
*
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Postcode
Safety & Care Information
Emergency Contact
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In the event of an emergency, please list phone numbers where a friend or relative may be contacted during the course of the program
Name
Relationship
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Activity Exclusion Requests
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Are there any specific activities that you do not wish to participate in?
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Swim Level
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Everyone can swim well
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Medical Information
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ADD/ADHD
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Asthma
Dizziness/Fainting
Epilepsy or Fits/Convulsions
Medication on camp
Recent illness
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Other
Any special Dietary Requirements?
Please provide further details for any of the above
COVID-19 Declaration
I declare that if my child is unwell with COVID-19 symptoms before camp, I will withdraw them from camp with written notice to Scripture Union. Upon withdrawal for this reason, I will receive a full refund. I understand that if I do not notify Scripture Union before camp starts and my child does not attend, no refund will be given.
I understand that there will be a Scripture Union COVIDSAFE plan in place for this camp, which I must agree to. I acknowledge that a form will be emailed to me, which I must sign and bring with me when signing in my child to camp.
I acknowledge that in the event that my child shows two of the four COVID-19 symptoms (fever, cough, shortness of breath, sore throat), they will be tested for COVID-19 at the closest clinic and isolated until a result is available. If they are found to be positive for COVID-19, I understand that I am responsible to come and collect my child and may be required to self-isolate with them.
In the event that there are changes in restrictions, we reserve the right to cancel our camps, in which case you will receive a full refund or given the option to transfer monies to another programs.
Participant Signature
*
I have read and agree to the COVID-19 Declaration
Camp Terms & Conditions
I am aware in signing this document for my participation in 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 Scripture Union 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 Scripture Union, its leaders and staff. In the event of an emergency where my nominated contact people are unavailable:
I authorise the leaders to obtain medical advice and/or assistance which they deem necessary.
I further authorise qualified practitioners to administer anaesthetic if required.
I accept all operation, blood transfusion and/or anaesthetic risks involved in the event that such procedures are deemed necessary.
I accept the responsibility for payment and agree to pay medical, transport, and any other related expenses.
I confirm that the information contained in this application is true and correct.
I agree to inform the leader of any change to these details.
I understand that the camp leaders will take all responsible care whilst at camp and that SU WA or its representatives will not be liable in any injury or accident, or for damage or loss of property.
Agreement
*
I agree with the terms and conditions for participating in the Camp
Photo Consent
*
I give permission for photos taken on camp to be used in future advertising
Yes
No
Payment Information
Please complete your details and select your payment options. Please note that the minimum deposit required is $50 per person
TOTAL
TOTAL
TOTAL
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Health Care Card (10% off)
Large Family Cap ($820) - for HCC/low income families
Please upload a photo or copy of your current HCC
*
Max. file size: 248 MB.
AMUC Payment
Total
$ 0.00
Payment Method
*
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Bank Transfer (EFT)
Please use the following bank details to pay your camp fee
Account Name: Scripture Union WA
BSB: 036-044
Account Number: 106215
Reference: CM024 "Your Name"
Please use the following bank details to pay your camp fee
Account Name: Scripture Union WA
BSB: 036-044
Account Number: 106215
Reference: CM020 "Your Name"
How much would you like to pay now?
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Supported Credit Cards: MasterCard, Visa
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