Launch Camp 2023 • Willows Presbyterian Church

Launch Camp Registration Form

Parents/Guardians, please complete the following information to register your child for Launch Camp. If you have any questions about the camp, please contact the director Simon Allery simon@willows.org.au / 0400 904 989.

Date: 1-5 April 2023

For: Students grade 10-12

Cost: $170 - Please note that this year's camp is being slightly subsidised by the remaining money from Launch 2022. This will not always be the case and fees could be back to normal prices next year.

Location: Quinola Lakes, Malanda

Speaker: Rev Zac Brasch

Cut-off date: add

PLEASE NOTE: THERE IS TRANSPORT FROM TOWNSVILLE (CARS) AVAILABLE AND A BUS FROM CAIRNS

Please note that there might be restrictions for camp to follow that are related to COVID 19, these will be outlined closer to the camp and will align with government regulations at the time. Should the camp be cancelled due to COVID 19 we will refund as much of your rego fees as is possible. Closer to camp we will send out information regarding what to bring, what time to arrive and payment.

Child details

First Name *

Last Name *

Gender *

Date of Birth *

School Grade in 2023 *

Have you been to Launch Camp before? *

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?

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

Medicare Number (please enter numbers only, no spaces or / ) *

If no medicare number exists, please enter 000 and give a reason in the 'other information' field.

Medicare Card Expiry Date

Family Doctor/Medical Centre

Family Doctor/Medical Centre Phone Number

Can Panadol be administered to the attendee if required? *

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

Give a short description of any dietary requirements - leave empty if none

Give a short description of any further allergies (medication, animals, plants etc) - leave empty if none

If the attendee has any other medical, psychological, social, behavioural or other conditions that should be known by the Camp Director, please list them below or contact the Camp Director directly.

Camp activities

During camp your child will be able to participate in some specialised activities. These include:

Swimming / Water slide

Outdoor Games

Trip to Atherton

By submitting this registration form you give permission for your child to participate in all of the specialised activities listed above. If you do not want your child to participate in one or more of these activities, please indicate below.

Please list any activities you DO NOT want your child to participate in - otherwise leave blank:

Can the attendee swim? *

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

Your agreement with Presbyterian Church of Queensland (PCQ):

You acknowledge 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 who need it to enable them to perform their approved activities (e.g. Camp Director, First Aid officer). Unless you explicitly advise otherwise, you consent to appropriate use by us of photographs taken on the program that include your child, such as in our official publications including websites and social media platforms.
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 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 Camp Director of any change to these details. You are welcome to contact our office (07 47231232) in relation to issues regarding your personal information and for a copy of our Privacy Policy.
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.

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.

Willows Presbyterian Church