Camp Application Form 2021
The Heathgrove 2021 camp will be held at Log Cabin Camp, 270 Ascot-Creswick Rd, Creswick VIC 3363 ( from Tuesday January 12 to Friday January 15. Girls in years 5, 6, 7 and 8 are able to apply (2021 school year). The theme of the camp is "Aladdin". An information session about the camp will be held later in 2021. We will be going to the campsite via coach departing from Heathgrove Study Centre.

The Heathgrove Camp will be "Technology free". We would prefer for all campers not to bring any form of technology (mobiles, iPod, iPad, etc) to the camp.
Email address *
Daughter Name and Surname *
Home Address
Daughter's Mobile No. (if applicable)
Date of birth *
Current age (as of January 2020)
School Name (for 2020)
School Year (2021)
Religion/ Belief
Does your daughter suffer from any allergies? *
If yes, please specify allergy and treatment
Please provide details of any dietary requirements
Does your daughter suffer from any medical conditions?
Clear selection
Please provide details of condition and treatment below
Please provide Medicare Number and Private Insurance details (if available) *
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