Youth Retreat

7 July, 2024 9:00 AM - 9 July, 2024 4:00 PM

38 out of 40 remaining tickets available

Type

Price

Quantity

Youth

38 Remaining

Price
$200.00

Quantity

Youth 0

Youth Retreat 2024

Information:

Dates: 7th -9th July 2024

Who: Grades 6 - 12

Where: Upper Plenty Conference Centre

45 Stokes Track, Upper Plenty VIC 3756

Cost: $200

Non-refundable deposit payable at the time of registration - $50

**Pick up and drop off for camp will be at Suburban Church.**

Drop off - 7th of July - 9 am (before our Sunday morning Service) - leaving between 11:30 am and 12 pm.

Pick up - 9th of July - Between 4 pm - 5 pm.

We plan to drive together to camp in cars or hire minibuses, but we will confirm this closer to the camp date. If you have any concerns, please chat with Zoe Walter about this.

Participants Details

First Name

Last Name

Date of Birth

Gender

School Grade

Home Address

Home Address Line 2

Home City

Mailing Postcode

Medical and Dietary Requirements

Medicare Card Number and Position

Private Health Name

Private Health member Number

Yes

Health Care Card Number

Expiry Date

Ambulance Cover *

Ambulance Member Number

Any disabilities or conditions the participant may have eg. Asthma, ADHD, sleep walking, travel sickness, bed wetting etc.

Medications

Dietary Requirements

Any other relevant information you may want to give

Emergency Contact

Should be contactable throughout the week all the time

Emergency Contact Name *

Relationship to participant *

Emergency contact primary phone *

Emergency contact secondary phone

Doctors Name

Doctors Phone

Parent/Guardian Information

Contact 1

First Name *

Last Name *

Relationship to Camper *

Primary Phone

Secondary Phone

Email Address *

Contact 2

First Name

Last Name

Relationship to Camper

Primary Phone

Secondary Phone

Email Address

Further Information

Parent/Guardian Consent

I/we authorise the camp directors to consent, where it is impractical to communicate with me/us to the camper receiving such medical/surgical treatment as may be deemed necessary. I/we accept responsibility for any costs involved in seeking said medical/surgical treatment for the camper. I/we understand that Suburban Church and its employees do not accept liability for the loss of property or damage or personal injury arising from the use of facilities or equipment, except where Suburban Church and its employees are negligent. I further understand and agree to the camper participating in any and all activities Suburban Church may see for and safe to run, including but not limited to water-based and adventure-based activities. I/we accept that Suburban Church bears no responsibility for campers other than during the advertised camp times, for which the camper has been registered and accepted unless previously arranged for and accepted in writing by both/all parties.
I (parent/guardian name), being the parent or legal guardian of the camper, agree to the parent/guardian consent and enter my name here as a digital signature, giving this consent authority.

I Agree *

I consent for photos and videos to be taken of my child during the camp to be used for the purposes of promotion of future camps by Suburban Church and for the creation of a video which will be distributed to other campers and parents at the end of the camp.

Photo Consent *