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Healthy Mind Happy Family Camp Registration Form
**If you have any cold/flu like symptoms, please notify us before the camp.**
Date: 12-14 June
Event Address: 959 Buxton-Marysville Rd, Marysville VIC 3779
Email:
lighthouse.gatewaysda@gmail.com
Price: 0-4yo free, 5-11yo $50, 12yo and above $100
* Indicates required question
Full name of camper 1 (i.e. Sarah Lee - 8yo)
*
Please provide the age for each camper under 16 years old.
Your answer
Full name of camper 2 (optional)
Please provide the age for each camper under 16 years old.
Your answer
Full name of camper 3 (optional)
Please provide the age for each camper under 16 years old.
Your answer
Full name of camper 4 (optional)
Please provide the age for each camper under 16 years old.
Your answer
Full name of camper 5 (optional)
Please provide the age for each camper under 16 years old.
Your answer
Full name of camper 6 (optional)
Please provide the age for each camper under 16 years old.
Your answer
Do you or anyone registered with you have any special dietary requirement? Please specify
Your answer
Your mobile number
*
Your answer
Your email
*
Your answer
Your emergency contact person details
Name and Mobile number (Must not be the same person that coming to camp with you)
Your answer
How did you hear about this event?
Friend
Website
Facebook
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Other comments?
Your answer
For safety of all campers, please sign the consent below
*
I acknowledge that this is a Christian camp and I will follow the rules of the camp organisers.
I understand that alcohol and smoking in the premise are not permitted.
Required
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