Overnighter - Registration
Overnighters are open to those in years 5, 6, 7 or 8 at school. Please complete one form for each child you wish to register.
Select the Overnighter you are registering for *
CAMPER DETAILS
Details of the child attending the overnighter
First Name *
Your answer
Last Name *
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Gender *
School *
Your answer
Year at school *
Home address *
Your answer
Details of any allergies, dietary requirements, special needs, behavioural issues or custodial restrictions we need to know about.
Your answer
If medication is required at camp, please list the following below: Name of medication; Dosage; Time to be administered; Health condition it is required for.
Your answer
PARENT/CAREGIVER/EMERGENCY CONTACT 1
The person we should contact first in the event of an emergency
Emergency contact 1 - first name *
Your answer
Emergency contact 1 - surname *
Your answer
Relationship to camper *
Emergency contact 1 - phone number *
Your answer
Emergency contact 1 - email address *
Your answer
PARENT/CAREGIVER/EMERGENCY CONTACT 2
An alternative contact person if we cannot contact the first person
Emergency contact 2 - first name *
Your answer
Emergency contact 2 - surname *
Your answer
Emergency contact 2 - phone number *
Your answer
Relationship to camper *
PARENT/GUARDIAN DECLARATION
I agree and acknowledge that LifeSwitch and Camp Staff have my permission to arrange any necessary urgent medical treatment at my cost. I will notify LifeSwitch of any changes to registration information immediately. I am happy for my child to appear in videos or photos of camp activities that might be used for promotional purposes. I consent to my child being transported to off site activities.
PARENT/GUARDIAN CONSENT *
Required
PARENT/GUARDIAN NAME *
Your answer
EMAIL ADDRESS FOR CONFIRMATION & GEARLIST *
Your answer
PAYMENT
To make payment of the $20 registration fee please deposit it into the following bank account: LifeSwitch 06-0545-0014111-26. Please use your child's name and 'OVERNIGHT' as references.
Payment is required before your place at camp can be confirmed.
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