Square One Camp • St John's Maroubra

Date

8 November, 2024 - 10 November, 2024

Type

Price

Quantity

Whole Camp

Price
$240.00

Quantity
One Day

Price
$120.00

Quantity

Applying discount...

Whole Camp 0

Camper Details

First Name *

Last Name *

Email Address *

Mobile Number *

Date of Birth *

School Grade *

Parent/Guardian Information

Parent/Guardian 1

This is also the first person contacted in an emergency

Contact 1 - Name *

Contact 1 - Mobile *

Contact 1 - Email *

Parent/Guardian 2

*Can be Jim, Ash or Anna if needed*

Contact 2 - Name *

Contact 2 - Mobile *

Contact 2 - Email *

Health and Care Details

Medicare Details

Medicare Number

Medicare Ref#

Ambulance Cover? Yes/No

Dietary Needs, Allergies and Medications

Does your child have any allergies or dietary requirements? *

Yes

Please list allergies and/or dietary requirements: *

Do they have an Action Plan? *

Tip: Please email the action plan to office@stjohnsmaroubra.com

Other Health and Care Information

Any other care needs we should know about?

Tip: ie. sleep conditions, behavioural, etc.

Do you give permission for your child to take paracetamol if required? *

Yes

Is there anyone who is legally restricted from seeing your child? *

Yes

Please provide relevant information: *

Is your child capable of swimming more than 30m unassisted?

Yes

T-Shirt Size (Kids sizes: 6, 8, 10, 12, 14)? *

Consent and Permissions

I authorise the St John's ministry leaders, in the event of an emergency, to obtain at my expense any medical, ambulance, rescue or other services that are considered necessary for my child. *

Yes

I give permission for photos/videos of my child taken at St John's and/or Youthworks events to be displayed publicly (online and in print) unless I advise the children and youth leaders otherwise. *

Yes

I give permission for my child to travel by car to Port Hacking Conference Centre with a leader or a parent. *

Yes

One Day 0