For full functionality of this page it is necessary to enable Javascript. Event ID Publish StatusPlease select... In Progress Published FORM ID 4733141 Adult Registration Fee Contact ID Registration AvailabilityPlease select... Register Waitlist Closed Concession Registration Fee Activity Instance ID Instance ID Filled?Please select... No Yes Concession Registration AvailablePlease select... Yes No Family Discount AvailablePlease select... Yes No Event NOT cateredPlease select... Yes No Merchandise Available?Please select... Yes No VirtualPlease select... Yes No Contains Swimming ActivityPlease select... Yes No Event Specific Ques IncludedYesNo Additional Event Specific Ques IncludedYesNo Include EOI custom questionsYesNo NOT Catered for Special Dietary NeedsYesNo Payment Required?Please select... Yes No Payment in Full RequiredPlease select... Yes No Team Directors Email Registrations have closed for this event. Please visit our website for other available events. I am registering: Note: If you require an invoice for NDIS purposes, please contact the office on [email protected] before filling out the form Payment is mandatory to secure your registration for this eventPlease ensure that you have your credit card details on you before filling out this form as your application responses will not be submitted unless credit card details are provided. For event typePlease select... SU Camp SU School Group (ISCF, SUPA Club) SU Mission (SUFM, SUmmerlife) Other On behalf of (please choose from three options)Please select... Myself (aged 18 or over) My child (aged under 18) Someone else (aged under 18) Event name SU Activity Name Event Start Date Event End Date Event overnightTrueFalse Event overseasTrueFalse Non-residentialYesNo I am interested in signing up for: For event typePlease select... SU Camp SU School Group (ISCF, SUPA Club) SU Mission (SUFM, SUmmerlife) Other Event name SU Activity Name On behalf ofPlease select... Myself (aged 18 or over) My child (aged under 18) Someone else (aged under 18) Contact Details First Name (Participant) Last Name (Participant) Date of Birth DD/MM/YYYY e.g. 01/01/2010 First Name (Parent/Guardian/Carer) Last Name (Parent/Guardian/Carer) Email If under 18, email of parent/guardian/carer Mobile phone If under 18, number of parent/guardian/carer What is your relationship with the child participant?Please select... Parent Guardian Case Worker Other Event Specific Questions Question 1:No conference leader will be permitted to drive students with less than a minimum of 1 year on their green licence and completed the SU drivers declaration form. Answer ‘yes’ to give permission for your child to be driven by authorised conference leader. Answer 1: Question 2: Answer 2: Question 3: Answer 3: Additional Event Specific Questions Q4. A4. Q5. A5. Q6. A6. Participant Details This section can be replicated for each person being registered. Registration TypePlease select... Adult Concession AgePlease select... 18+ 16-17 11-15 6-10 1-5 <1 Registration Fee $ Concession Registration Fee $ First Name (Participant) Last Name (Participant) Age Date of Birth School Name Year at School (Next Term) Email (Participant) Required if over 18 otherwise optional Mobile Phone (Participant) Street (Participant) Town / Suburb (Participant) State (Participant)Please select... NSW ACT QLD VIC SA NT TAS WA Post Code (Participant) Please SelectFemaleMale Friends (under separate registrations) that the participant is attending with Medical Information Does the participant have any dietary requirements or allergies?Please select... No Yes Type of Dietary Requirement / AllergyPlease select... Dairy Egg Fish Gluten Lactose Peanut Sesame Shellfish Soy Tree Nuts Wheat Vegetarian Vegan Other Severity LevelPlease select... Severe/Anaphylactic Significant/Sensitivity Intolerance Minor/Traces Acceptable Personal Preference Please Describe "Other" Is there an anaphylaxis / allergic reaction action plan for any allergies listed? NoYes Upload anaphylaxis / allergic reaction action plan A reaction plan is required for those with severe allergies. An Epi Pen will need to be readily available. Medicare Card No. Insurance and Member # Health Fund Details Details of Last Tetanus Shot If needed, may we administer Paracetamol?YesNo If needed, may we administer Ibuprofen?YesNo If needed, may we administer Antihistamines?YesNo Is the participant currently on any prescribed medication?Please select... No Yes Current Medications that Participant is Prescribed Medication Name / Dosage Amount / Time to be Administered Medications that participant has recently stopped using Does the participant have ambulance cover?Please select... Yes No Does the participant suffer from any of the following:AsthmaAnxietyBehavioural IssuesEpilepsy / Fits / ConvulsionsSleep WalkingHearing ImpairmentSight Impairment Please Describe: Swim AbilityPlease select... Non swimmer Fair Swimmer - may need some assistance for more than 50m Typical Swimmer - can swim up to 100m unassisted Good Swimmer - can swim more than 100m unassisted Physical AbilityPlease select... Limited Function Normal Function for Age Advanced / Athlete Reading LevelPlease select... Behind for Age Normal for Age Advanced for Age Are there any other things that we need to be aware of, particularly anything that might affect the health, safety or well being of the participant? (i.e. mental health challenges, previously fractured bones, etc) Any special needs, health conditions, non-food allergies, etc Event Specific Questions Q1.No conference leader will be permitted to drive students with less than a minimum of 1 year on their green licence and completed the SU drivers declaration form. Answer ‘yes’ to give permission for your child to be driven by authorised conference leader. A1. Q2. A2. Q3. A3. Additional Event Specific Questions Q4. A4. Q5. A5. Q6. A6. Overseas Additional Event Questions Q9. A9. Q10. A10. Q11. A11. Q12. A12. Is anyone legally restricted from seeing the camper?Please select... Yes No Full name of the restricted person Registration Fee For This Participant $ Registration Quantity Parent / Guardian / Carer's Details First Name One Name Only Last Name Mobile Phone Email Street Town / Suburb StatePlease select... NSW ACT QLD VIC TAS NT WA SA Postcode Relationship to ParticipantPlease select... Parent Guardian Case Worker Other Emergency Contact Name Must be different than Primary Contact Emergency Contact Phone Must be different than Primary Contact Relationship to Participant Emergency Contact Name #2 Must be different than both other contacts Emergency Contact Phone #2 Must be different than both other contacts Relationship to Participant Site / Holiday Address If applicable (eg in holiday park) Permission for Online Meetings Please confirm that you give permission for your child to participate in online meetings below:I give permission for my child to participate in online meetings run by SU NSW and its approved volunteers. All online meetings and video conferences (including ‘Breakout Rooms’) may be recorded for security purposes. Recordings will be securely stored on Scripture Union NSW private server. A “Waiting Room” (or similar) will be used to ensure only those with parental permission or those invited to the meeting enter the video conference and to prevent one leader and one participant being alone in a meeting if they join early. Two trained and approved leaders will be present at all times in any online situationThere will to be no one-on-one video conferencing with participants under 18 If children are Primary age, parents are encouraged to be present/nearby during online meeting. I would like to receive Meeting ID & Password byEmailSMS PARTICIPANT AGREEMENTI agree to abide by the following guidelines for behaviour and participation All participants must be in public or family spaces (e.g. not in bedrooms) All participants must be appropriately attiredNo bad or offensive language shall be usedNo ‘private’ chats will be allowed. All chat comments will be public and seen by allNo screen sharing except by leadersNo custom backgroundsI recognise that failure to comply with these guidelines may result in my being excluded from the online meeting Permission and Indemnity I permit my child / children to fully participate in this Scripture Union NSW activity. In the case of a medical emergency I give permission to Scripture Union to attain medical assistance for my child / children. I understand that every effort will be made to contact me prior to initiating such. I permit my child to be transported as described in the information about the activity, or as otherwise may be required in emergency circumstances. Personal details will remain confidential and will not be provided to others except as may be required by Law.The Scripture Union privacy policy is available on our website www.sunsw.org.au.Please note: alcohol, cigarettes, electronic cigarettes (vapes) and recreational drugs are prohibited on all SUNSW camps and missions or programs involving children or other vulnerable people. Please untick the below only if you DO NOT wish for your child to be photographed I grant Scripture Union permission to use photographs and video taken throughout this event of my child for news and promotional materials. Scripture Union may contact you by email or post occasionally throughout the year to let you know about future Scripture Union events. I would like to receive communications from Scripture Union. Total Registration Fee $ Total Registration Quantity Additional Items Additional Items Item Name DescriptionAll participants will be provided a Leadership Conference 2023 Hoodie (no charge). Please use the size guide MENS SUPPLY HOOD - 5101 Measurement XSM SML MED LRG KLG 2XL 3XL Body Width (cm) 49 52 55 58 61 64 67 Body Length (cm) 69.5 72 74.5 77 79.5 82 84.5 Unit Price Quantity Click on "Remove" to delete the below additional items from this order Price $ Merchandise TypePlease select... Resource Promotional Insurance Other Clothing Total $ Size Additional Items Item Name DescriptionTo Be Confirmed Unit Price Quantity Click on "Remove" to delete the below additional items from this order Price $ Merchandise TypePlease select... Resource Promotional Insurance Other Clothing Total $ Size Total Additional Items Cost $ Payment Summary Have you made, or do you wish to make, an application for Kids to Camp financial assistance (overseas camps excluded from funding)?Please select... Yes No Full or Partial Support?Please select... Partial Support Full Support Support Amount Requested $ If you wish to make an application for financial assistance from the Benevolent Fund (excluding - overseas camps), please email [email protected]. Would you like to make an additional donation to support this ministry?Please select... Yes No Select the Amount you would like to donate $20 $50 $100 $200 Other Enter the Amount you would like to donate $ Payment Summary Total Number of Registrants Family Member Discount % Discount Calc Total Registration Cost $ Total Merchandise Cost $ Total Donation $ Total Amount Payable $ Please note that PAYMENT in FULL is required to secure your registration for this event. Are you currently able to pay for this registration?Please select... Yes No Please enter the amount you are able to pay for currently $ Remaining Payable in Future $ Payment Information Name on Card Card Number MM Charge ID YY CVV Billing Email Total Amount reCAPTCHA helps prevent automated form spam. 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