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Tui Ridge Camp, Rotorua 5th - 6th April (Year 5 and 6s).
This form is for medical, dietary and emotional well-being for camp participants (children and parents). Please inform the school if any of the information provided in the form changes between now and camp.

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Email *
Parent/Guardian Full Name: *
Participants Full Name: *
I give permission for my child to attend this camp and travel to and from the camp with a fully licensed car driver. *
Please tick if any of the following conditions apply *
Required
If "other" please specify
Is your child on any medication? *
If so, please specify Health Condition, Medication Required, Dosage and Time given. Any further information is appreciated.
Has the participant had any major injuries in the last 6 months that may limit full participation (broken bones, strains, glandular fever, shingles etc)?
Overnight events *
Required
If "other" please specify
Allergies: Is the participant allergic to anything (prescription medication, food, insect bites/stings). If YES, please specify allergy and treatment required. Please include food allergies in the dietary section also. *
Please state the "Action Plan" in case of an allergic reaction.
Does the participant have any special dietary requirements? If YES, please specify.  If your child is allergic to any foods, we have a 'Dietary Allergy Waiver' form for you to fill out as requested from the camp. This can be collected from the School Office or emailed upon request.  *
I give permission for pamol/paracetamol to be administered if required: *
To the best of your knowledge, has the participant been in contact with any infectious diseases in the last 4 weeks? If YES, please specify.
Are there any other information that teachers and camp staff should be aware of to ensure the physical and emotional safety of your child (cultural practices, anxiety, fear of heights, fear of the dark, fear of confined spaces, behavioural or emotional concerns)? *
Parent Helpers Only- Please let us know of any medical conditions that we should be aware of.
Parent Helpers Only- please let us know if you have any special dietry requirements...
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