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24 hour Rock Solid Camp Registrations
****FOR PARENTS / CAREGIVERS to fill out **********
Fill in all blanks to register yourself for an AWESOME camp - '24 Hour' Camp
Make sure you click the "submit" button at the bottom of page to register. Please only register Once. If you a registering more than one person fill out a separate form for each person by clicking "Submit another response" on the confirmation window. After you have done the first registration. Cost $35 . Payment details below.
Payment we prefer it done online through our "Rock Solid Youth Trust" ASB account 12-3093-0326942-00
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* Indicates required question
First Name
*
Your answer
Surname
*
Your answer
Date of Birth
*
i.e. 25 April 2005
MM
/
DD
/
YYYY
Sex
*
Male
Female
Address
*
Street Number and Road
Your answer
Suburb
*
Suburb eaample KAMO
Your answer
City
*
City example WHANGAREI
Your answer
Postcode
*
Postcode eg 0112
Your answer
Home Phone
*
ie. 09 4386059 or 09-4386059 (please include area code leave a space between 09 and the ph number)
Your answer
Work Phone
ie. 09 4386059 or 09-4386059 (please include area code leave a space between 09 and the ph number)
Your answer
Mobile Phone
*
Please put in this format ie. 021 782547 or 021-782547
Your answer
Email Address
*
IMPORTANT: Please double check you have entered email correctly as we will use this as main means of communication with you.
Your answer
Ethnicity
*
Ethnicity of children or Leader: Our funders require us to report back percentages of NZ Maori, Pacific Islanders, etc on our camp. We solely just present as a percentage so your child is never identified. Please select from list below or write in the other option.
NZ Maori
Pacific Islanders
NZ European
Other:
RS Club
Select the Rock Solid Club you attend. Or if you don't attend Rock Solid which is your closest Rock Solid club area. This camp is mainly for Whangarei Rock Solid but some years some other young people from other Rock Solid clubs join us.
Whangarei
Dargaville
Other:
Clear selection
Any Important Medical Info
*
Is your child / teen currently on medication for anything. if YES please explain. Also include Any Special Medication/ Food allergies or requirements? Write NONE if it does not apply
Your answer
Asprin or Panadol
*
is the camper able to have asprin or panadol administered for minor first aid?
Yes
No
Camper or Leader
*
IMPORTANT: Please indicate whether you are Camper, Leader, Junior Leader or Leaders Child. CAMPER = (10-14 yrs old (Students Year 6, 7 & 8), LEADER (18yrs up), Junior Leader (15 - 17 yrs), Leaders Child (under 9 yrs old)
Camper
Leader
Junior Leader
Leaders Child
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