Participant Medical Information
Every person (adult and child) attending Kaitoke Outdoor Education Centre programs must provide the below information
Participant Personal Details
First Name *
Last Name *
Address *
Participant Caregiver Details
Full Name *
Contact Phone Number *
Participant Dietary Information
All questions below are relating to the participant attending camp
Do you have any dietary requirements/ food allergies? *
Comments
If yes, please state below e.g gluten free
Participant Medical Information
All questions below are relating to the participant attending camp
Please tick if any of the below statements relate to you
Notes *
Please provide further information below if any of the above boxes were ticked. Otherwise just type 'no'
Do you give permission for Y Staff to use photos including the above person for marketing purposes? *
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