Junior Camp Registration 2022

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Camp organized by Orienteering Queensland, 7-10 July, Stanthorpe region.

This form MUST be filled in by a parent/guardian.

Please fill in a separate form for each participant.
NB: The personal information on this form is confidential, and will be retained only for the duration of the camp, after which time it will be destroyed.

Email *

Name of person completing this form (must be parent/guardian)
*

First & last name of camp participant *

Date of birth *

YYYY

Medicare number *

Health Fund name & number (if any)

Home address *

Participant mobile phone (if any)

Parent/Guardian name *

Parent/Guardian phone (emergency contact) *

Parent/Guardian email *

Additional Parent/Guardian contact details (name, mobile, email)

Doctor's name and phone number *

Special dietary requirements *

None

Dairy-free

Gluten-free

Vegan

Vegetarian

Other:

Required

Any allergies? (give details of severity and action required)

Does the participant suffer from asthma? (give details of severity and action required)

Is the participant currently suffering from any injury or condition which is likely to be aggravated by physical activity?

Immunisation history *

All standard childhood vaccines

Chicken pox

Covid-19

None of the above

Other:

Required

Date of last tetanus vaccine (if known)

Which medications is the participant currently taking (if any)?

Which of the following may be given to the participant? *

Panadol

Aspirin

Nurofen

Antihistamine

None of the above

Required

Any other relevant medical history

Transport arrangements *

Participant needs transport to arrive at camp

Participant has own transport to arrive at camp

Driver may be able to take additional passenger(s) to camp (indicate how many under "Other")

Other:

Required

Transport permission *

I give permission for my child to be transported by car during the camp (to and from activities) by a driver holding an open license.

Other:

Required

Code of conduct

Please read the Camp Participant's Code of Conduct: https://eventor.orienteering.asn.au/Documents/Event/13472/1/Camp-participant-code-of-conduct

Acceptance of code of conduct *

I have read and accept the Camp Participant's Code of Conduct . I have ensured that my son/daughter has read and agrees to abide by the Code of Conduct.

Parental/Guardian consent *

I hereby give consent for my son/daughter to participate in travel and camp activities, and agree that he/she be under the direction of responsible adults/coaches associated with camp at all times, and that he/she follow the outlined Code of Conduct. I hereby give permission for camp authorities to seek qualified medical attention for the above participant should it be necessary, and I authorise such qualified practitioners to administer treatments, anaesthetics, and transfusions if the need arises, and I understand that such medical attention will be to my cost.

A copy of your responses will be emailed to the address you provided.

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