Youth Camp Application


Parent(s) Details

Participant Details

N.B.: One form is required for each participant.

Residential Address

Photos and Video


Emergency Contact Details

Medical Details

Doctor's Details

Medication

Non-Prescription Medication

Restoration Church will have the following non-prescription medications available at camp. Should the participant require or request any of these medications, please indicate which of the following can be administered.



Prescription Medication

Please advise us if these circumstances change prior to departing for the camp.

Dietary Requirements


Allergies & Other Conditions



Epinephrine Pen


Mental Health

Camp Activities


N.B.: Not all of the activities listed above may necessarily be a part of this camps schedule.

Payment

Camp Cost: $320 per person


N.B.: You will not be held to this, this is an indicator only.

Financial Hardship



Liability Information

Liability Release
I acknowledge that the activities described in the schedule can be hazardous and that my child participates at his/her own risk. I understand that the church will take reasonable steps to provide a safe environment for my child and to ensure that all equipment supplied by them for the selected activities are of a reasonable standard.

Consent to Activities
I acknowledge that the church will not be liable for any injury that may be suffered by my child, which arises either directly or indirectly from, or in connection with, the activities described in the schedule incorporated in this form.

Consent to Medical Attention
agree that the church may authorise on my child’s behalf whatever medical treatment he/she may require (this includes, but is not limited to, ambulance attendance and hospital treatment) I agree to pay all medical expenses incurred.

Disclaimer
I hereby agree to indemnify the church against any and all claims arising from, or in connection with, any injury that may be suffered by my child, or that my child may cause to another person, as well as any loss or damage to property, equipment, or personal effects belonging to my child, or any other person, arising either directly or indirectly out of or in connection with the activity described in the schedule incorporated in this form.

Discipline
If in the event your child's behaviour is deemed by the organisers to be inappropriate or compromises the safety and/or health of other attendees on the camp, Restoration Church reserves the right to send your child home, at your expense, at the earliest possible time, in conjunction with your co-operation for collection at a suitable location.