Camp Registration – Young Adults Easter Camp

EASTER CAMP REGISTRATION

Hidden
Camp*
Read our Holiday Camp Application Process for information and FAQs regarding the registration process
Please read our current SUWA COVID Guidelines prior to registering
Also here are our Camping and Missions COVID Guidelines
Young Adults Easter Camp
Cost: $190 (includes food, and accommodation)
Age: 18 (*Post Year 12) – 25
When: 15 - 18 April 2022
Team Leader: Emily Brough
Gender*
Hidden
No places are currently available*
- Please put me on the waitlist!
Name*
First Last
Preferred Name (if different)
Date of Birth*

Day
Month
Year
Postal Address*
Street Address Suburb Postcode
Email*
Mobile*
Church (optional)
Optional: Who did you invite?
Optional: Who invited you?
Emergency Contact Information
Emergency Contact Name*
First Last
Emergency Contact Relationship*
Emergency Contact Phone*
Other Health & Medical Information
Past Medical Conditions
Hold the Ctrl (or cmd) button to select multiple
Current Medical Conditions
Hold the Ctrl (or cmd) button to select multiple
Current Medical Conditions - Other*
Special Dietary Requirements*
Do you have any special dietary requirements that SU should be aware of?
Dietary requirement details:*
Allergies*
Do you have any allergies - food, environmental, drug, other?
Please provide details (including severity & medications)*
Swimming Proficiency*
How well can you swim?
Tetanus Injection*
Have you had a tetanus injection in the last 10 years?
COVID Vaccination Status*
Please note: At this stage this will not have a bearing on whether you can attend or not.
Will You Need To Take Medication On Camp?*
- Yes
- No
Do you require any other medication (inc. ventolin spray, epipen)?*
List the medications and any instructions / details necessary.
Medicare Number*
Medicare Card Expiry*
Medicare Reference Number*
Please enter a number from 1 to 20.
Do you have ambulance cover?*
Your Feedback
Please take a moment to let us know more about how you found Scripture Union.
How did you hear about us?*
Agreement with SU WA
I am aware that this is a drug and alcohol free event, and I agree to abide by SU’s values for the duration of the event.

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 anesthetic if required.
- I accept all operation, blood transfusion and/or anesthetic 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 of my wellbeing 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. I understand that in cases of unacceptable behaviour, I will be sent home at my own cost.
I understand that this program may be cancelled at the last minute if minimum numbers are not meant, or in unforeseen extenuating circumstances.
Participant Agreement*
- I agree with the terms and conditions for participating on a Scripture Union WA camp.
Covid-19 Declaration
I declare that if I am unwell with COVID-19 symptoms before camp, I will withdraw 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, 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 in the event that I show two of the four COVID-19 symptoms (fever, cough, shortness of breath, sore throat), I will be tested for COVID-19 at the closest clinic and isolated until a result is available. If I am found to be positive for COVID-19, I understand that I will need to leave camp and am responsible getting myself home.

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. In the event of a high-caseload environment, we may be required to limit attendance to vaccinated participants only. If this change is required, alternative non-residential day programs will be offered where vaccination will not be required and full refunds will be available if needed.
Participant Signature*
- I have read and agree to the COVID-19 Declaration
Photo Consent*
Do you consent to appropriate use by SU WA of photographs taken on the program that include you?
Contact Consent*
Do you consent to a leader/church to continuing contact you after the event for follow up and future young adult event information?
Additional Information*
Are there any family, behavioural, mental health or medical conditions which require special attention we should know about? E.g. hearing or sight or other impairment, ADD or ADHD, court order or custody issues, formal counseling situations, or any other?
Please Provide Details*
Payment Information
Please complete your details and select your payment options.
Camp: Young Adults Easter Camp
Fee: $190
How would you like to pay?*
- Credit Card
- Bank Transfer
Once you have submitted your form, please contact the SU WA Office for payment details
Credit Card Payment
How much would you like to pay now?*
Payment amount:
$ 0.00
Credit Card*

MasterCard
Visa
Supported Credit Cards: MasterCard, Visa
Card Number Expiration Date Security Code Cardholder Name
Comments
This field is for validation purposes and should be left unchanged.

Young Adults Easter Camp

Emergency Contact Information

Other Health & Medical Information

Your Feedback

Agreement with SU WA

Covid-19 Declaration

Payment Information

Camp: Young Adults Easter Camp
Fee: $190

Credit Card Payment

SU Australia works alongside local churches and community groups to bring God’s love, hope and good news to children, young people and their families. Our heart is to see children and young people discovering life in God’s big story.

About Our Organisation

EXTRA LINKS

ADD/ADHD
Anaphylaxis
Anxiety
Appendicitis
Asthma
Bedwetting
Bronchitis
Chicken Pox
Depression
Diabetes
Ear Infections
Epilepsy/Fits
Fainting/Dizziness
Glandular Fever
Heart Problems
Measles
Migraines
Mumps
Pneumonia
Recent Broken Bones/Illness
Sleepwalking
Tonsillitis
Travel Sickness

ADD/ADHD
Anaphylaxis
Anxiety
Appendicitis
Asthma
Bedwetting
Bronchitis
Chicken Pox
Depression
Diabetes
Ear Infections
Epilepsy/Fits
Fainting/Dizziness
Glandular Fever
Heart Problems
Measles
Migraines
Mumps
Pneumonia
Recent Broken Bones/Illness
Sleepwalking
Tonsillitis
Travel Sickness
Other

Young Adults Easter Camp

Emergency Contact Information

Other Health & Medical Information

Your Feedback

Agreement with SU WA

Covid-19 Declaration

Payment Information

Camp: Young Adults Easter Camp Fee: $190

Credit Card Payment

Camp: Young Adults Easter Camp
Fee: $190