PURSUIT YOUTH CAMP UNITE

18 March, 2022 6:00 PM - 20 March, 2022 1:00 PM

1 out of 45 remaining tickets available

Type

Price

Quantity

Pursuit Camp Registraton

1 Remaining

Price
$100.00

Quantity

Pursuit Camp Registraton 0

Pursuit Youth Camp Registration

Parent/Guardian Information

First Name *

Last Name *

Mobile Number *

Mailing Address

Email Address

By completing this form I grant permission for my child to attend the Unite Youth Camp 2022 at Bornhoffen PCYC with the Pursuit Youth Ministry.[1]

I understand that all activities will be fully supervised and child safety protocol will be adhered to. In the case of an emergency, I give consent for my child to receive medical care if I or my alternative emergency contact cannot be reached.

[1] A Ministry of Forest Lake Baptist Church

Emergency Contact Information

Emergency Contact First Name *

Last name

Phone Number *

Relationship to child *

Alternative Emergency Contact Information

If for whatever reason I cannot be contacted, the alternative emergency contact person is:

Alternative Emergency Contact First Name: *

Alternative Emergency Contact Phone Number *

Last Name:

I authorise the leader in charge to arrange for my child to receive such first aid & medical treatment, as a trained first aid person may deem necessary. *

Yes

I authorise the use of calling an ambulance if it is judged to be necessary. *

Yes

I accept responsibility for payment of all expenses associated with such treatment. *

Yes

Medical Information

Are there any medical concerns that we should be aware of: *

Yes

If any medications are required for the duration of the camp, please list explicit instructions below and ensure you (the parent/guardian) bring their medication in the supplied container with the directions as supplied by the pharmacy. These medications must be handed to Ps Seb Henley by the parent/guardian to administered as described below.

Please list any medical conditions below

Child Information

First Name *

Does your child have any dietary requirements? *

Last Name *

Dietary Requirements

Liability Release

I acknowledge that camp activities can be hazardous and that my child/children participate/s at their own risk. I understand that the camp leaders take reasonable steps to provide a safe environment for my child/children and to ensure all equipment supplied by them for any activities is of a reasonable standard.

I hereby release and indemnify Forest Lake Baptist Church, its servants and agents, and any other persons involved with my child/children’s participation in the youth camp at Bornhoffen PCYC, on 18-20th March 2022, from all actions or compensation claims for personal injury or damage to or loss of property arising from my child/children’s participation.

I agree that in the event of accident or injury suitable medical assistance may be sought on my behalf from a qualified first aid officer or the Queensland Ambulance Services and that medical treatment may involve administering of generic pain relief products such as paracetamol.

I understand that my child has been requested NOT to bring any electronic devices to the camp and indemnify the organisers from any responsibility for my child’s property if brought along against this advice.

I recognise that being part of a community involves mutual care and consideration and therefore agree that unacceptable behaviour may result in our/my child being sent home (where myself or another designated adult is required to pick them up) and/or being temporarily prohibited from camp activities.

Privacy Agreement

How we collect, hold, use and disclose information about you is important to us. Personal information collected by us is only used for the running of Pursuit Youth activities and may be used to provide emergency health care and recording incidents involving your child. The purpose of collection, holding, use and disclosure of the information is only to fulfil the ministry and administrative functions of the Pursuit Youth Camp 2022.

Photography/Video Agreement

As part of attendance at the Pursuit Youth Camp, I give permission for my child to have their photo/video taken and stored by Pursuit Youth. Video footage and photographs will be taken to record youth events and may be used to promote Pursuit Youth in both print and digital formats, including website and social media. You may withdraw this permission at any time by contacting Pastor Seb Henley at seb.henley@flbc.org.au or 0434 050 222.

Thank you for providing this important information which will be kept confidential and only shared with those who need to know. The safety and wellbeing of your child is our primary concern.