REGISTRATION FORM

Please complete one registration form per child.

Name *
Name
Address
Address
Date of Birth *
Date of Birth
Parent / Guardian of Participant *
Parent / Guardian of Participant
Does your child have any medical conditions? *
Please advise us if your child/ren has special dietary requirements. We will do our best to work with you and your child/ren to ensure they are looked after during camp. *Medication will need to be handed to the medication officer, and will be distributed as required.
Permission
I give permission for my child/children to attend Public Youth Winter Camp, 09th - 11th July, 2019 as outlined on info sheet. I give permission for authorized leaders to provide medical assistance at any time they consider necessary whilst my child is in their care. I acknowledge that I will be liable for any expense incurred in the treatment of my child. I also understand that while every reasonable precaution will be taken to ensure the protection of my child, I hereby release and hold harmless Public Youth leaders from any and all liability in the event of injury, accident or misfortune, damage or loss to their property. I give the adult leaders of Public Youth permission to transport my child in a private vehicle if the situation should arise. I also give the Leaders permission to act as a guardian on my behalf if I am unable to be contacted in an emergency. I understand that Public Youth events may be captured on photograph and video. Public and Camp Drewe reserves the right to use this material during events and for promotional purposes.