MAX 2019 Participant Application

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MAX 2019 Applications closed in early June. Please contact the Participant Coordinators Edith and Risyad on pc.max@lordsomerscamp.org.au if you wish to put in a late application.

To be eligible to attend MAX you must have completed at least one Lord Somers Camp and Power House program as staff and not have been a Grouper at Big Camp 2019

Name *

Date of Birth *

YYYY

Phone number *

Email address *

Please provide the name and contact number of a LSC&PH member who you have previously worked with *

i.e Phoebe Watson Activites HOD Camp Diversity 2017B

What Lord Somers Camp and Power House programs/camps/community camps have you attended? *

Please include: Roles/Departments and years attended

Will you be able to attend the full duration of the program? MAX runs from Sunday 7th-Saturday 13th July *

Yes

Other:

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