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COVID-19 Update 1st February 2021
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God is with us!
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Short-term mission with a twist
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From the director
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2020
LEAD Summer and Junior LEAD camps
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LEAVERS REGISTRATION
Hidden
Camp
*
Leavers Ningaloo
Leavers Kalbarri
Leavers Coral Bay
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
Leavers Ningaloo
Cost: $1275
Age: Year 12 in 2022
When: 19th - 27th Nov 2022
No places are currently available
*
Please put me on the waitlist!
Grade Level (in 2022)
*
Please Choose
Year 12
Gender
*
Please choose
Male
Female
Shirt Size
*
XS
S
M
L
XL
XXL
XXXL
Pick Up Location
*
Perth
Geraldton
Learmonth Airport
I don't require transport
Leavers Kalbarri
Cost: $1,175
Age: Year 12 in 2022
When: 20th - 27th Nov 2022
No places are currently available
*
Please put me on the waitlist!
Grade Level (in 2022)
*
Please Choose
Year 12
Gender
*
Please choose
Male
Female
Shirt Size
*
XS
S
M
L
XL
XXL
XXXL
Pick Up Location
*
Perth
Geraldton
I don't require transport
Leavers Coral Bay
Cost: $1,275
Age: Year 12 in 2022
When: 18th - 26th Nov 2022
No places are currently available
*
Please put me on the waitlist!
Grade Level (in 2022)
*
Please Choose
Year 12
Gender
*
Please choose
Male
Female
Shirt Size
*
XS
S
M
L
XL
XXL
XXXL
Pick Up Location
*
Perth
Geraldton
I don't require transport
Hidden
Camper's Name
*
First
Last
Preferred Name (if different)
Date of Birth
*
Day
Month
Year
Postal Address
*
Street Address
Suburb
Postcode
Camper's Email (optional)
Camper's Mobile (optional)
Camper's School
*
Camper's Church (If Any)
Optional: Who did you invite?
Optional: Who invited you?
Parent / Guardian Information
Parent or Guardian Name
*
First
Last
Parent / Guardian Relationship
*
Choose A Relationship
Mother
Father
Aunt
Uncle
Grandparent
Caseworker
Carer
Other Guardian
Parent / Guardian Phone
*
Parent / Guardian Email
*
Emergency Contact Name
*
First
Last
Emergency Contact Relationship
*
Choose A Relationship
Mother
Father
Aunt
Uncle
Grandparent
Caseworker
Carer
Family Friend
Sibling
Other Guardian
Emergency Contact Phone
*
Must be different to the primary contact provided above
Campers in Care
*
This child is under the protection of the Department of Communities
Yes
No
Other Health & Medical Information
Past Medical Conditions
Hold the Ctrl (or cmd) button to select multiple
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
Current Medical Conditions
Hold the Ctrl (or cmd) button to select multiple
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
Current Medical Conditions - Other
*
Special Dietary Requirements
*
Does your child have any special dietary requirements that SU should be aware of?
No
Yes
Dietary requirement details:
*
Allergies
*
Does your child have any allergies - food, environmental, drug, other?
No
Yes
Please provide details (including severity & medications)
*
Camper's Swimming Proficiency
*
How well can your child swim?
Swimming proficiency
Cannot Swim
Fair
Well
Tetanus Injection
*
Has your child had a tetanus injection in the last 10 years?
Choose an answer
Never
Don't know
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
Will Your Child Need To Take Medication On Camp?
*
Please include any non-prescription medications your child is taking on camp
Yes
No
Does your child require any other medication (inc. ventolin spray, epipen)?
*
List the medications and any instructions / details necessary for your child.
Do you give permission for the First Aider in charge to administer the following non-prescription medications in an emergency?
*
Important: The team will only keep a limited amount of these medications. If your child requires more, please provide them.
Paracetamol
Ibuprofen
Antihistamines
None of the above
Medicare Number
*
Medicare Card Expiry
*
Medicare Reference Number
*
Please enter a number from
1
to
20
.
Does your child have ambulance cover?
*
Choose an answer
No
Yes
Activity Exclusion Requests
*
Are there any specific activities that you do not wish your child to participate in?
Choose an answer
No
Yes
Exclude My Child From The Following Activities
*
Your Feedback
Please take a moment to let us know more about how you found Scripture Union.
How did you hear about us?
*
Choose an answer
Recommended by a friend
Received a brochure by post
Have been on SU Camps in the past
Email
Church
School Chaplain
Other school contact
Search Engine
Eternity Newspaper
Advocate Newspaper
Sonshine Radio
Facebook
Other
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 in the event that my child shows any of the 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.
Parent / Guardian Agreement
*
I have read and agree to the COVID-19 Declaration.
Agreement with SU WA
I am aware in signing this document that my child and/or the child or young person that I am the caregiver for (hereinafter referred to as ‘my child’) could, by participating in this program, be exposed to certain elements of the program that could be physically and emotionally demanding.
Furthermore, I understand that certain inherent risks and dangers may exist in the activities in which my child will be participating and that these risks and dangers can cause injury, damage, or other loss. I acknowledge that while SU Australia 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 SU Australia, its leaders and volunteers, and its staff.
I understand that SU Australia will take all responsible care of my child whilst at camp and that SU Australia will not be liable in any injury or accident, or for any damage or loss.
While it is our policy to contact and consult with parents/guardians when outside medical help is required for my child, I recognise that some medical emergencies are time-critical and a delay may result in death or permanent disability. Therefore, in the event of a time-critical and/or life-threatening emergency:
I authorise SU Australia to arrange for medical care and treatment by qualified practitioners (including but not limited to evacuation, hospitalisation, blood transfusions, anaesthetic, surgery, and medications).
I authorise SU Australia to transport my child (or arrange for transport) to a medical facility.
I accept all the risks inherent in the medical care and treatment, and transportation, referred to in a) and b).
I agree to pay all costs associated with the medical care and treatment, and transportation, referred to in a) and b).
I agree to the release by SU Australia of any information or records necessary for the medical care and treatment, transportation, any referral, billing, or for other relevant purposes.
I understand that in cases of unacceptable behaviour, campers will be sent home from camp.
I confirm that the information contained in this application is true and correct and agree to inform SU Australia of any change to the details I have provided.
Parent / Guardian Agreement
*
I agree with the terms and conditions for sending a participant on a Scripture Union WA camp.
Photo Consent
*
Do you consent to appropriate use by SU WA of photographs taken on the program that include your child?
Choose an answer
Yes
No
Child Contact Consent
*
Do you consent to a leader continuing contact with your child after the event, within SU policy guidelines and with your full knowledge of details and purpose?
Choose an answer
Yes
No
Additional Camper 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?
Choose an answer
No
Yes
Please Provide Details
*
Press submit to apply for a place on this camp.
Apply
Press SUBMIT to apply for a place on this camp. We will process applications in the order they are received and let you know if you have a place on camp or if you are on the wait list.
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