2017 AUTUMN YOUTH VISION CAMP

CONSENT TO ATTEND FORM

PARENT / GUARDIAN - PLEASE READ AND SIGN

This form is accessible.

  1. I do / do not consent for my child (print name of camp participant) …………………..…………………… to participate in the 2017 Autumn Youth Vision Camp at Milson Island Sport and Recreation Centre and participating sporting venues from Wednesday 19th April to Sunday 23rd April 2017.
  2. I understand that the 2017 Autumn Youth Vision Camp is a residential camp and that my child will be provided with sleeping accommodation in the grounds of the Centre
  3. My child will be travelling to camp by: private car (drop off at Brooklyn Wharf, opposite Hawkesbury Train Station)or public transport / BS NSW bus from Strathfield train station departing at 11.30am on Wednesday 19th April from Platform 1 on M4 side of the station
  4. My child will be leaving camp by: private car (drop off at Brooklyn Wharf, opposite Hawkesbury Train Station) or public transport/ BS NSW bus from Milson Island Sport and Recreation Centre to Strathfield train station arriving at 5:00pm on Sunday 23rd April to the Platform 1 on M4 side of the station
  5. I give do not give permission for my child to travel by bus and/or car to and from camp and sporting venues
  6. I agree do not agree that in the event that my child is unable or unwilling to cooperate safely that I will arrange for collection of my child from the Camp as soon as possible, after being informed by BS NSW
  7. I acknowledge that there are risks involved in participating in the activities offered at the Camp. I acknowledge that these activities are conducted with the expectation that my child is able to understand instruction and safely co-operate in the activities. I givedo not give permission for my child to participate in these activities
  8. I givedo not give permission for my child to participate in the water or swimming activities under supervision from a qualified life guard at all times
  9. I understand that Milson Island Sport and Recreation Centrewill supply floatation devices (life jackets) for all water sports (except swimming) and that my child will need to wear covered shoes when participating in water sports, except swimming
  10. I advise that my child also requires the following floatation device to assist him/her in the water: …………………………………………………
  11. I undertake to provide this device so that my child can participate in the excursion yes no
  12. Where it is impractical or not possible to communicate with me, I agree do not agree to Camp administration to obtaining hospital or medical treatment and at my expense, including ambulance fees, should my child require it
  13. I give do not give permission for the First Aid Officer to administer paracetamol if needed
  14. I give do not givepermission for my child to be treated with head lice shampoo if needed
  15. I accept do not accept financial responsibility for any damages incurred by my child whilst at the Camp
  16. I agree do not agreeto my registration information provided to be made available to relevant staff and medical professionals where necessary
  17. I agree do not agree to allow camp organizers to use my child’s name, any photographs, and sound and film recordings taken of my child at this camp for the promotion of the camp to the media and to the general public.

Name of parent / guardian (print):

Relationship to camper:

Signature: ………………………………………………….

Date:

For more information, please contact the Camp Coordinator Murray or Tami Elbourn:

  • phone 0427 186 734 or 0431 268 561email

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