CHILD REGISTRATION

Name

First Name

Last Name

Gender

Date of Birth

MM

DD

YYYY

Email

Phone

Church and School and Name of friend coming to camp if you would like to be in the same group.

Parent/Guardian Details

Contact 1

First Name

Last Name

Relationship with child

Email

Mobile

Contact 2

First Name

Last Name

Relationship with child

Email and Phone Contact

Medical History relevant to camp

Dietary Requirements

Medicare Number and Health Insurance

Permissions

Please tick the following boxes giving your permission for

MEDIA CONSENT Photographs and videos may be used, in an un-identified form, as part of future Friends Camp promotional material and also published on the Total Immersion website, social media platforms and end-of-camp slideshows and videos. Use of such media content is considered a condition of booking. Please indicate if you do not grant media consent.

I give permission for my child to attend Total Immersion Friends Camp. I release Yiwarra Palya Ministries and all individuals from liability in case off accident during activities related to Total Immersion Friends Camp, as long as normal safety procedures have been taken.

Child REGISTRATION FEES

Registration Fees

For One - $120 per person which includes sponsorship (obtain by organisers)

For Three or more

If no sponsorship - $450 per person. (government agency)

Cost includes all meals, all activities and accommodation.

I have deposited the appropriate camp fee into the Yiwarra Palya Ministries Bank Account. BSB 086 712 Acc. No. 87284 5756

APPLICATION FOR YOUNG LEADERS

Name

First Name

Last Name

Gender

Date of Birth

MM

DD

YYYY

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

Email

Church

Tell us about how you became a Christian?

Tell us why you would like to be a young leader at Friends Camp

Pastor / Youth Leader / Adult Christian comment of support

Committment

I will attend all meetings and participate with a servant attitude.

Working with Children Check Number (if over 18)

Medical History relevant to camp

Dietary Requirements

Medicare Number

Health Insurance - if applicable

Young Leaders registration fee

Registration Fees

$100 per person deposited into the Yiwarra Palya Ministries Bank Account. BSB 086 712 Acc. No. 87284 5756

APPLICATION FOR adults

Name

First Name

Last Name

Gender

Email

Phone

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Names of children responsible for

Church

Working with Children Check number

Medical History relevant to camp

Dietary Requirements

Medicare Number

Health Insurance - if applicable

Adult REGISTRATION FEES

Registration Fees

$100 per person deposited into the Yiwarra Palya Ministries Bank Account. BSB 086 712 Acc. No. 87284 5756