» Senior Camp Enrolment

First name of student*

Last name of student*

Date of birth*

Emergency Contact #1 Name*

Emergency Contact #1 Phone Number*

Emergency Contact #2 Name*

Emergency Contact #2 Phone Number*

Best Contact Email*

Do you agree to pay camp fees of $440 per student?*

Would you be willing to donate an additional $40 to contribute to epic camp merchandise? (No pressure)

Would you like to book a place on a coach (with seatbelts) for the journey to and from the TOPS conference centre?

Price will be determined based on number of passengers (approx $40 per person)

Do you require linen at an additional cost of $16 per person?

Does the student have any medical issues or injuries?

Asthma
Epilepsy
Anaphylaxis
Injury
Other

If yes, please describe below:

Does the student have any allergies?

If yes, please describe reaction and treatment required below:

Does the student require any medications to be administered while on camp?*

Please note: all medication will be stored securely and administered by a teacher or parent helper

If yes, please describe below:

Does the student have any dietary requirements?*

If yes, please describe below:

Is the student afraid of heights?*

Has the student spent more than a night away from home before?*

Any other special instructions?

In the case of an emergency, do you give permission for our teachers to call 000, and perform first aid if the situation requires it, and agree to incur the costs of that service?

Senior Camp Enrolment

Senior camp enrolment form 2023