Northern Easter Camp

Aside from Easter Camp collecting information, Eastgate also needs to collect some important details for each camper...

Youth Details

Youth First Name *

Youth Last Name *

Youth Email Address *

School Grade *

Emergency Contact Name *

Emergency Contact Mobile *

Medical Information

Is your child taking any medication currently? *

Yes

Please give details of the medications and dosages. Youth are only permitted to have epipen and inhalers in their personal luggage. Our camp parent will keep and administer all other medication. *

Please detail what special care or treatment is recommended *

Does your child have any allergies to the following?

Please detail what special care or treatment is recommended *

What was the date of your child's last tetanus injection? (approx date is acceptable) *

Do you give permission for your son/daughter to be given a tetanus injection if the doctor recommends it? *

Yes

Does your child have any further medical concerns that could influence their participation in any activities or have other special instructions that the leaders should know about? *

Tents

Do you have a large tent we could use for the camp?

Yes

How many people does your tent sleep?

Disclaimers

Medical Liability Release:

I agree that my child should take part in such activities and such necessary duties as may be required by leadership. I understand that Eastgate Christian Centre will not accept responsibility for loss or damage of personal property (check own household policy).

I authorise Eastgate Christian Centre staff to administer ‘over-the-counter’ medication as required and within the manufacturer‘s guidelines. I authorise the obtaining, on my behalf, any medical assistance, if, in the opinion of the staff, such treatment is necessary, and agree to meet any costs incurred.

I release Eastgate Christian Centre, its agents, employees and volunteer assistants from any liability whatsoever arising out of an injury, damage or loss which may be sustained by my child during the course of his/her involvement with the Eastgate Christian Centre Youth programme.

PLEASE NOTE: The staff of Eastgate Christian Centre have taken all practical steps to identify hazards and minimise risk on this activity. All adults involved have been informed and prepared for their supervisory role.

All reasonable steps have been taken to manage this activity safely and responsibly.

By ticking yes, I (the parent/guardian) agree to the above medical liability release. *

Yes

Participant and Parent/Guardian Agreement:

Eastgate Christian Centre will keep all information private and confidential. Team members may use photographs and videos from Eastgate activities on our printed materials and online. Please contact us in writing if you prefer your child to not appear in print or online.

I agree that to the best of my knowledge, all of the details given are true and correct.

I acknowledge this camp will have Christian elements. I agree to follow all instructions from those in charge of this camp and understand that no smoking, alcohol or illegal drugs are permitted. Failure to follow these instructions may result in instant removal from camp at own expense.

I release Eastgate Christian Centre from any responsibility from any accidental physical injury or illness while on the trip.

By ticking yes below, I (the parent/caregiver) agree to the above participant and parent/caregiver agreement. *

Yes

Privacy

INFO: Eastgate collects your information for communication and administration. We do not sell or share it and keep it confidential to staff. You can request access to or deletion of your information at any time.

IMAGES: Eastgate uses event photos/videos for promotion, which may include your face. By giving permission, you waive rights to royalties. If you withhold permission, we respect your choice but cannot ensure images of your back/body wont appear.

Five days to build your friendship with Jesus and your friendship with others? Yes please!

Camp Attendee 0

Youth Details

Medical Information

Tents

Disclaimers

Privacy