NQX2026 Camper Registration • Willows Presbyterian Church

NQX26 Registration Form

Parents/Guardians, please complete the following information to register your child for NQX26. If you have any questions about the camp, please contact the camp director Luke Doyle on luke@willows.org.au / 0438 748 343.

Date: 21-25 September 2026

For: Students grade 7-12

Cost: $295 - please talk to us if money is an issue. If you have 3 youth attending you only need to pay for 2.

Location: Camp Barrabadeen, Lake Tinaroo

Speaker: Damon Scott

Please register by the 11th of September

PLEASE NOTE: THERE IS LIMITED TRANSPORT FROM TOWNSVILLE AND A SMALL BUS FROM CAIRNS

Should camp be cancelled due to unforeseen circumstances we will refund as much of your registration fees as is possible. After completing this registration form you will receive information about payment for the camp in an email.

Child details

First Name *

Last Name *

Gender *

Date of Birth *

School grade *

Parent/Guardian details

Parent/guardian name *

Relationship to attendee *

Street address *

Suburb *

State *

Postcode *

Parent/Guardian Mobile Number *

Parent/Guardian Email Address *

Are there any custody or family issues relating to your child that the camp director should be aware of? *

Please list any custody or family issues relating to your child. *

Which church do you attend (if any)?

Emergency contact details

First contact in emergency (name) *

First contact in emergency (phone) *

Second contact in emergency (name) *

Second contact in emergency (phone) *

Medical details

Note: any medical information given here will only be used for NQX26 and not for Townsville Pressie Youth or any other church activities. If your child attends Townsville Pressie Youth, and need to update your child's medical information, please use the Medical form on our website, found HERE, to do so.

Does your child, have or ever had, any medical conditions? *

Tip: (for example: Asthma, Heart Problems/Disease, Diabetes, High Blood Pressure, Bleeding Condition, Recent Illness of Injury, Mental Health or Disabilities)

Please provide details of medical condition. (eg. asthma, date of last episode, medication taken) *

Does your child have any allergies? (eg: medication, food, animals, plants, materials etc) *

List all allergies (eg: medication, food, animals, plants, materials etc) *

Will the attendee need to take any tablets or other medication during the course of the camp? *

Information about medication that needs to be taken. (ie. medication name and dosage amount and timing) *

Tip: It is the responsibility of the carer to inform of all medical conditions and medications prescribed for the camper by their doctor to be taken while on camp.

Can Panadol be administered to the attendee if required? *

Does your child have any dietary requirements? *

Please list the dietary requirements *

Does your child have any other medical, psychological, social, behavioural or other conditions? *

Please provide details of any other medical, psychological, social, behavioural or other conditions. *

Please provide information about how they process big feelings and what signs to look out for, and helpful strategies to support them when dealing with emotions. *

Camp activities

Your child will participate in a number of Low Risk activities including:

- ball games (soccer, volleyball etc), board games, 'minute-to-win-it' style games, Amazing Race style activity, outdoor games, art/craft activites, sessions and small groups as examples.

Your child will be able to participate in a number of Adventure Activities during camp, including:

- Raft building, campfires, camping (tent and dorm), bushwalking, swimming.

We will also travel offsite:

- via bus to Atherton and Lake Eachham.

You may be contacted about additional activities closer to the camp.

By submitting this registration form (including agreement with the PCQ Waiver & Standfirm Adventure Consent and Wavier listed below) you give permission for your child to participate in all of the activities during camp. If you do not want your child to participate in one or more of these activities, please indicate below.

Are there any specific activities you do not want the attendee to participate in? *

Please list any activities you DO NOT want your child to participate in. *

Can the attendee swim? *

Rafting Building

This year at NQX, campers and leaders will have the opportunity to participate in raft building, provided/operated by Standfirm Adventures. As part of their safety requirements, Standfirm Adventures requires every participant, both campers and leaders, to provide the information below.

Are you currently pregnant? *

If yes, how many months? *

>>>STANDFIRM ADVENTURES - CONSENT AND WAIVER

I acknowledge that I have read and understand the Gather and Gain liability waiver, and give permission for my child or myself to participate in Gather and Gain (Standfirm Adventures) activities. *

How will the attendee be transported to and from camp? *

Please give more information about how your child will be transported. *

Which size shirt would you like? *

Can photos and videos be taken of the attendee? *

Yes

Yes, but not their name published

Can photos and videos be taken of the attendee? *

Terms and Conditions

By submitting this form, you acknowledge and agree to the following:

1. Privacy:

Protecting your privacy is important to us. The information we seek allows us to manage risk, provide reasonable care and administer involvement in our program. We will not disclose personal information to any third party, unless compelled by law, but provide it only to those who are acting on behalf of the Presbyterian Church of Queensland (PCQ) who need it to enable them to perform their approved activities (e.g. Event Director, First Aid officer, Standfirm Adventures/Gather & Gain). Unless you explicitly advise otherwise, you consent to appropriate use by us of photographs taken on the program that include your child, including inclusion in our newsletter, web page or a brochure. You are welcome to contact our office (07 3106 3266) in relation to issues regarding your personal information and for a copy of our Privacy Policy.

2. Medical:

You also acknowledge that while the Presbyterian Church of Queensland and its agents will make every reasonable effort to minimise exposure to known risks, every hazard associated with activities cannot be foreseen or may be beyond the control of the Presbyterian Church of Queensland and its agents. In the event of any emergency where your nominated contact people are unavailable, you authorise the Presbyterian Church of Queensland (PCQ) and its agents to obtain medical advice and/or assistance which they deem necessary. You further authorise qualified practitioners to administer anaesthetic if required. You accept all operation, blood transfusion and/or anaesthetic risks involved in the event that such procedures are deemed necessary. You accept the responsibility for payment and agree to pay medical, transport and any other related expenses. You confirm that the information contained in this online registration is true and correct. You agree to inform the Event Director of any change to these details.

3. Refund Policy:

We will always seek to refund as much money as we possiblly can. This will be worked out on a case by case basis and in consultation with those involved.

4. Risk Warning and Waiver:

You have read and agree to the full PCQ Risk Warning and Waiver. In summary you acknowledge that by participating in any activities arranged by PCQ or its agents, certain risks or dangers may occur and you agree to unconditionally release, waive, discharge and forever hold harmless, the PCQ or any of its employees, agents, directors or officers, from any claims as a result of any personal injury sustained, whether caused by negligent act or wilful act or omission, breach of contract, breach of statutory duty, error, or otherwise in connection with or arising out of the Activities.

>>>PCQ WAIVER

I have read and accept the terms of the PCQ Waiver. *

Yes

Parental Permission

I understand that by clicking 'SUBMIT':

I give permission for my child to attend this camp; and
I will pay the appropriate camp fees.