Kids Camp Winter - Life's a Pic-a-nic
Our Kids Camp theme this camp is "Yogi Bear - Life's a Pic-a-nic."  Send the kids along for a week of fun filled antics and memory making.  We have fabulous food and plenty of activities to keep them entertained and amused!  Learn how to be a Team player and make new friends!
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Which camp will this child be attending? *
Campers First Name *
Campers Last Name *
Campers Gender *
Campers Date of Birth *
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Campers Age at Camp *
Home Address *
School/Homeschool *
Please note any medical conditions *
Please note any medication required *
Please note any dietary requirements *
We are unable to offer catering for Coeliacs, Vegan or restrictive diets.
Does your child have any other needs we should  be aware of? *
Please specify - such as bedwetting, homesickness, behavioural issues
Do you give permission for Lakes Ranch to administer paracetamol, panadol or ibuprofen? *
Lakes Ranch may provide these medications if necessary for the comfort of your child
Name of Parent/Caregiver *
Email of Parent/Caregiver *
Mobile Phone of Parent/Caregiver *
Name of Emergency Contact *
Relationship to Child *
Email of Emergency Contact *
Mobile Phone of Emergency Contact *
Do you consent to your child being sent follow-up information and studies by Lakes Ranch? *
Is there anyone who is not allowed access to this child?
If yes, please provide names in the space provided.
Is there anyone this child would like to be in a cabin with?  They may choose 1 person. *
We do not put boys and girls together, and our cabins are age related,  We do not guarantee they will be in the same cabin but we will try our hardest.
Payment Details *
A non-refundable $100 deposit is required to secure place. This will need to be paid online. Balance can be paid in cash at registration or online no later than 3 days prior to camp starting.
Who will be picking this child up from camp? *
If this changes you must notify the camp before camp finishes.
Photography Permission *
We provide a camp photo to all campers.  Does this child have permission to be in this photo?  We do not use it for advertising.
Declaration by Parent/Caregiver *
1. I consent to all the information supplied in this form being used for the purpose of running the camps and agree that my child will abide by camp rules. 2. In the event of sickness or accident I authorise that qualified medical attention be secured and notification followed by any expenses sent to me at the above address. 3. I agree that staff and leaders will be clear of all liability in the event of any injury or loss which the camper may sustain to person or property. I also agree to pay for any damage incurred by my child to any Lakes Ranch property, by either accident or malicious intent. 4. I acknowledge that the $100 deposit is non refundable, payment required to secure place.  I have read, understood and agree to this.
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