Grace Youth Camp 2019 – REPRESENT – Rego Form

REPRESENT

Camp Details

Date: 19th-21st July
Drop off: Friday 7:00pm @ Orana Camp Ground - 146 Roches Beach Rd, Roches Beach
Pickup: Sunday 11:30am @ Church - 1 Chipmans Rd Rokeby
Cost: $99
Speakers: Craig Guntrip, Sam Miles, Kelsy Westcott
Main camp contacts: Luke Denholm - 0438 615 687, Sarah Brett - 0474 906 122
First Aid contacts: Sarah Brett - 0474 906 122, Francis Pascal - 0428 646 226

YOUNG PERSON'S DETAILS

PARENT / GUARDIAN'S DETAILS

Can we pray for your young person? *
Can we take photos of your young person for promotional purposes? *
Disclaimer
I am aware this activity may be challenging physically, emotionally and spiritually and realise that, in spite of the planning processes of the group, members may experience situations where they encounter unpredictable and unforeseen risks and acknowledge, despite precautions and supervision, accidents may happen.
I understand that in the event of any illness or accident, every effort will be made to contact me, but if this is not possible, I authorise any Leader to sign on my behalf, any written form of consent required by medical providers (including the administration of anaesthetic if required) and accept all associated costs.
I understand that the information collected on this form will be used for the purposes of fulfilling Grace Youth objectives and duty of care for my child and will be treated securely and not be passed on for commercial purposes.
I agree to these conditions *

PAYEE DETAILS

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CREDIT CARD DETAILS

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