Elevate Camp 2018

ELEVATE CAMP 2018
Use this form to register yourself for Elevate Camp 2018!

For details on camp, please visit thriveyouth.com.au/camp

Before you begin - you will need a lot of your personal and medical details. It's helpful to have your parent/guardian with you to fill out this form. If you have any questions you can ring the church on 4639 1777!

Begin registration below!
I am registering...*
Your Name

First NameLast Name
Your Email
example@example.com
Contact Name

First NameLast Name
Contact Email
example@example.com

Camper Details

Enter the details of the person attending camp.
Which Youth is the camper from?*
Full Name*

First NameLast Name
Gender*

MaleFemale
Date of Birth*

DayMonthYear
E-mail
Home Phone

State CodeHome Phone
Mobile Phone*
Address*

Address

Address Line 2 (Optional)

SuburbState

Postcode

Blue Card Details

Working with children check.
As you are over 18 you are required to have a blue card to attend camp.
As the camper is under 18 you are not required to complete this section of the form.
Does the camper have a blue card (working with children check)?

YesNo, I need to apply
Card Number
Card Expiry

DayMonthYear
Name as on Card
To attend camp, you will need to have a blue card issued to you. You must apply as soon as possible as there can be delays of up to a month. You will not be allowed on camp without a verified blue card.

You may continue with your registration, but your attendance on camp is subject to your approval and receival of your blue card.

Medicare / Health Fund

These details are required in the case of an emergency where professional medical treatment of the camper must be secured.
Medicare Number*
IRN*
Does the camper have private health cover?*

YesNo
Health Fund Name
Membership Number
IRN

Other Health Questions

Please answer these questions as completely as possible. Does the camper...
Get travel sickness?*

YesNo
Have any allergies?*

YesNo
Allergy information. What is the camper allergic to? What action needs to be taken in case of a reaction?
Need to take medication whilst on camp?*

YesNo
Medication information. Medication name, what is it for, frequency it needs to be taken.
Have any dietary needs?*

YesNo
Please provide information about your dietary needs.

Terms of Attendance
The terms of attendance outline what the campers parent/guardian must agree to in order for the camper attend camp. Since you are not the parent/guardian, before the registration is accepted we will need to contact the parent/guardian to verify this registration. Please provide their details below
Parent / Guardian Name

First NameLast Name
Contact Number
Mobile Preferred
Contact Email
example@example.com
The terms of attendance outline what you must agree to in order for you to attend camp. In a nutshell, you agree to...
- Allow us to secure professional medical treatment (EG: hospital) of the camper if the need arises
- Administer first aid to the camper if the need arises
- Release us from all liability related to the campers health & their personal property
- Allow us to take photos/videos of the camper
- Allow us to use photos/videos of the camper in promotional material for Thrive Youth/New Hope Church
- Allow us to store and use contact details of the camper to contact the camper and parent/guardian about Thrive Youth / Elevate Camp
The above outline is an overview only. You must read the full terms & conditions to agree. By ticking below, you state that you fully understand and agree to the terms & conditions.

Full Terms of Attendance
TERMS

For the sake of this agreement "Thrive Youth" refers to all staff and volunteers of New Hope Church, the camp director and the leaders of Elevate Camp. Thrive Youth also refers to New Hope Church Ltd, its staff and members.

"The camper" refers to the individual whose details have been used to fill out this form.

ACTIVITIES

I acknowledge that activities undertaken at Elevate Camp can be hazardous and that the camper participates at their own risk. I understand that Thrive Youth will take reasonable steps to provide a safe environment for the camper and to ensure that all equipment supplied by them for activities is of a reasonable standard.

I acknowledge that Thrive Youth will not be liable for any injury that may be suffered by my child, which arises either directly or indirectly from, or in connection with, the activities undertaken on camp.

LOSS

I hereby agree to indemnify Thrive Youth against any and all claims arising from, or in connection with, any injury that may be suffered by the camper, or that the camper may cause to another person, as well as any loss or damage to property, equipment or personal effects belonging to the camper, or any other person, arising either directly or indirectly out of or in connection with the activities undertaken on camp.

MEDICAL TREATMENT

I agree that Thrive Youth may authorise on the campers behalf whatever medical treatment they may require (this includes, but is not limited to, ambulance attendance and hospital treatment) and I agree to pay all medical expenses incurred. I understand that Thrive Youth will first make reasonable attempt to contact the emergency contact as filled out in this form, prior to securing such treatment.

PHOTOS & VIDEOS

I hereby consent to Thrive Youth to take or have taken by others, photographs, digital images and/or audio and/or video footage (the images) of the camper, and to store the images, make copies of the images and publish the images in any form, in whole or in part, and distribute them in any medium for the promotion of Thrive Youth or Elevate Camp.

I understand that Thrive Youth shall undertake not to use any images in a way that would cause embarrassment or misrepresent the intent of the campers participation.

I understand that neither the camper or the parent/guardian of the camper will be paid for giving this permission and I hereby waive any claim that I or we may have or may have had for remuneration, residuals, royalties or any other payment in respect of use of the images.

PRIVACY

I permit Thrive Youth to store and use the personal and contact details of the camper covered in this form to contact the camper or their parent/guardian in relation to their involvement with Thrive Youth and Elevate Camp. I understand that this information is never sold or released to third parties, and shall only be used in relation to their attendance at Thrive Youth or Elevate Camp.

Section End
Sign Here

Clear

Payment

A minimum $50 deposit is required by September 1st to secure your place at camp.

Get $15 off if you pay in full before July 31.

Please choose whether you'd like to pay now or later.
Financial Situation*

I should be able to pay for camp myselfI may need partial assistance to pay for campI will not be able to come to camp unless someone pays for me
How much do you think you would be able to put towards camp?
Camp Deposit is $50. This is a good place to start if you're unsure.
Payment

CashCredit CardDirect Deposit (Online Transfer)
Cash Payment

Cash payments can be made to the New Hope Church office. You can pay at
- Mid-week during office hours
- Friday Night Youth
- Any Sunday Service
Online Transfer

You can make an online transfer using your internet banking portal. Use the following details to make the transfer:
- BSB: 064 433
- Account: 1111 4016
- Account Name: New Hope Church Ltd Toowoomba
- Reference: EC18-{fullName6}
Psst! Use code "EARLYBIRD" to get $15 off a full registration before July 31st.

Our credit card portal is currently offline. Please phone the church if you would like to pay by credit card and we can process this over the phone
Should be Empty:

Camper Details

Blue Card Details

Medicare / Health Fund

Other Health Questions

Terms of Attendance

Payment