Camp Application Form 2019
The Heathgrove 2019 camp will be held at Log Cabin Camp (www.logcabincamp.com.au) from Thursday January 17 to Sunday January 20. Girls in years 5, 6, and 7 are able to apply (2019 school year). The theme of the camp is "Survivor".

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. Parents will be able to contact their daughters for emergencies through Carmen Pavia on 0405 385 644 or calling the camp site on (03) 5345 2756 . The Heathgrove camp management team will provide updates to parents via WhatsApp.

Daughter Name and Surname *
Your answer
Home Address
Your answer
Daughter's Mobile No. (if applicable)
Your answer
Date of birth *
MM
/
DD
/
YYYY
Current age (as of January 2019)
Your answer
School Name (for 2019)
Your answer
School Year (2019)
Your answer
Religion/ Belief
Your answer
Does your daughter suffer from any allergies? *
If yes, please specify allergy and treatment
Your answer
Does your daughter suffer from any medical conditions?
Please provide details of condition and treatment below
Your answer
Please provide details of any dietary requirements
Your answer
Please provide Medicare Number and Private Insurance details (if available) *
Your answer
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