Youth Camp Registration Participant's InformationName *Age *Current School Attendance *Year Level *Any medical conditions, allergies, medicine, dietary requirements? If needed, can your child / children take Panadol, Ibuprofen or antihistamines? Parent's/Caregiver's InformationParent's / Caregiver's Name *Parent's / Caregiver's Name Address *Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeAfghanistanAlbaniaAlgeriaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCentral African RepublicChadChileChinaColombiaComorosCongo (Brazzaville)CongoCosta RicaCote d\'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast Timor (Timor Timur)EcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFijiFinlandFranceGabonGambia, TheGeorgiaGermanyGhanaGreeceGrenadaGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiKorea, NorthKorea, SouthKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorwayOmanPakistanPalestinian TerritoryPalauPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint VincentSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited States of AmericaUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamWestern SaharaWestern SamoaYemenZambiaZimbabweCountryPhone *Email * Transport We may need help with transport to, and or from, Wainui. Let us know below if you are able to helpCan you help with transport? All drivers need to be appropriately licensed, and cars having a current WoF, insurance and registrations.I can help with transport out to Wainui Camp on Friday afternoonI can help with transport back to Christchurch on Sunday afternoonI can help with transport both waysIf you can help, how many people can you take Please don't include the driver Parent Helpers at CampParent Help We need parents to help during our camp - mainly in the kitchen with meals. Please indicate if you are able to help. Kaelyn will contact if you if you indicate that you are able to help.I am available to come as a parent helper for part of the campI am not available to come as a parent helper AuthorisationBy typing your name below, you agree to the following: I, the undersigned am willing that my child / myself should participate in the North Parish Youth Camp to be held from Friday night March 12th to afternoon Sunday 14th March. I understand that the nature of the activities during the program may include but not be limited to workshops, outdoor and indoor group activities, group accommodation, hiking, sports & challenge games, communal eating, socialising, travelling in motor vehicles and that although due care will be taken to minimise accidents risks may arise during these activities. I hereby authorise the leader in charge of the camp or the particular activity in which my child / myself is involved to consent, where it is impracticable to communicate with me or my nominated contact person, to my child / myself receiving such medical treatment or surgical treatment as the leader may deem necessary at any time during the camp. I hereby authorise and consent Catholic Parish of Christchurch North, its employees, volunteers, agents, officers, and contractors obtaining and administering medical assistance, including first aid, transport, blood transfusion and/or anaesthetic if required and I agree to indemnify Catholic Parish of Christchurch North its employees, volunteers, agents, officers, and contractors for any cost or liability arising out of the performance of any medical procedure in relation to such medical assistance. I further agree to indemnify Catholic Parish of Christchurch North against claims and losses of any kind arising out of or in connection with my / my child’s participation in any activities. I accept responsibility for payment of all expense associated with such treatment. I understand that every effort will be made by the camp leader firstly to contact me / my nominated person in the event of any illness or accident. My child/ I agree to abide by the rules / guidelines of the camp and to participate in all aspects of the program and I will accept full responsibility for costs incurred in removing myself/my child from the program if they seriously breach any such guidelines.Parent's Name *By typing your name, you agree to the above Photography & Images There will be times in which we will take photographs at camp. These images may include your children. We will make sure that only first names are used (if we use names). These images will be used for the promotion and reporting of our youth ministry within the Parish or Christchurch Diocese. Please let us know if it is ok to use images that may have your children in them.Permission for use of children's images *I give permission for images to be usedI don't give permission for images to be used Cost The cost is $55 per child ($100 for two siblings, and $40 for each subsequent child). Please don't let the cost deter you from sending your young person to camp. Please contact Kaelyn if you cannot afford or pay this cost, and we'll sort something out.Payment *There are two ways in which you can pay - internet banking or cash.CashInternet Transfer When paying by internet banking the account details are: Catholic Parish of Christchurch North 03-1592-0207367-20 with the references 'Youth Camp' and 'Child's Name'. For cash, please drop this off at the parish office at 26 Cotswold Ave in an envelope marked Youth Camp & Child's Name. VerificationPlease enter any two digits *Example: 12This box is for spam protection - please leave it blank: