Riverbend Kids Camp Registration

Riverbend Kids Camp Registration

Easter Kids Camp: 26-30 April 2021
This form has been created for the purpose of submitting information to Riverbend Bible Church for use in their Kids Camp. Please note that completing this form does not guarantee a space at camp.

Once this form has been completed someone from Riverbend will be in touch to discuss the information and for payment of the camp.

By completing this form you are agreeing to all terms and conditions and if the camper is accepted into camp they are agreeing to abide by all camp rules.

If you would like to register more than one child, then you will need to complete a separate registration (this form) for each child.

Camper information
Please provide all relevant details for the camper that will be attending camp.
Camper's Name *

First Name Last Name
Camper's Date of Birth *

Day Month Year
Date
Age: (Auto Calculated)
Camper's Gender *

Male Female
School Year *
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Rooming Requests

This is for REQUESTS only, NO promises. Children are put in cabins within similar age groups. (Males and females will sleep in separate cabins)
Request #1

First Name Last Name
Request #2

First Name Last Name
Are you happy for your child to sleep on a top bunk *

Yes No
Restricted Access
Is there anyone who is not allowed access to the camper? *

Yes No
If yes, please provide the name of the person who is NOT allowed access to the camper
Relationship to camper
What is their relationship to the camper? Father? Aunty? Etc.
Details
Please send supporting evidence of this as we must have proof in order to enforce it.
Upload documentation (If applicable):

Cancel of
Medical, Behavioral and Dietary Information
Please provide any relevant or helpful details on the camper
Dietary Requirements

Gluten Free Dairy Free Egg Free Nut Free Vegetarian Vegan Anaphylactic Other
More Information
Medical Issues
Disability
Behavioral issues
Please specify any medication that the camper may be taking during camp
Medication must be supplied in a clearly labelled container which will be signed in to the Camp Parent at Registration.
Do you give us permission to administer Paracetamol, if it is needed? *

Yes No
List full names of anyone who may pick up your child. If this changes please notify us as we will not allow your child to go home with someone who is not listed. *
Parent/Guardian/Caregiver Details
Caregiver name *

First Name Last Name
Relationship to camper *
Phone Number *
Caregiver Date of Birth *

Day Month Year
Date
Email *
example@example.com
Alternative Contact

This contact should be from a different householdthen the Parent/Guardian/Caregiver listed above. In an emergency, we will contact this person if we have been unsuccessful in our attempts to contact the primary contact.
Name *

First Name Last Name
Relationship to camper *
Phone Number *
Riverbend Terms and Conditions

Terms and Conditions

All information collected on this form is for the use of Riverbend Bible Church (RBC) for administration, follow-up, and emergency purposes. It may also be shared with government agencies for statistical purposes or where safety is a concern with Oranga Tamariki (MSD) or the police.

Payment for holiday camps is required at the time of registration. RBC reserves the right to cancel your booking if we believe we cannot safely accommodate your child as a part of our programme. Should this occur, we will refund you in full.

Children must be signed in and out of camp by a designated parent/guardian. RBC takes responsibility for the care of your child from when they are signed in until they are signed out at the end of camp. Please advise us of who will be picking up your child and do not leave or pick up your child without signing them in and out. If your child’s designated parent/guardian changes, you will need to let us know in writing. There is no supervision available for campers prior to camps start time, please do not arrive early.

As a church ministry, Bible-based talks are part of our programme. This time is used to show the relevance of the Bible to life and how to apply practical Christianity to everyday living.

We ask that you don’t phone your child during camp as it can be disruptive to the programme and unsettling for your child. In an emergency, you can contact the church office by phoning 06-873 0054 during office hours. We will contact you if your child is unwell or not coping with being away from home.

Behaviour
Our holiday camps are conducted by RBC Staff and are assisted by a volunteer team; including, but not limited to, volunteer leaders and helpers. Campers are in the care of leaders at all times and are expected to abide by all camp rules.
RBC has a zero-tolerance policy for bullying and harassment. Disruptive behaviour, deliberate misconduct or disrespect for the property at camp are taken seriously and may result in a warning or other appropriate follow-up.

Ongoing or serious behavioural issues will result in your child being sent home. If your child is sent home for behaviour issues, fees will not be refunded and any costs for damage or transport will be charged. Attendance to future RBC Camps will be by negotiation with RBC Staff. RBC does not accept registrations for children who would constitute a danger to themselves or other people.

Medical
For the safety of your child, and others, all medication is to be signed in at registration. RBC will ensure that all medication is stored and administered according to your instructions by a designated Staff Member or appropriately trained volunteer.
We do not supply cough or throat lozenges or any antihistamine medicines. If your child would normally need these, please send them to camp.
Please do not send your child to camp if they have had diarrhoea or vomiting 48 hours prior to camp commencing.

Cancellations
Any cancellations will incur a $50 admin fee. This will be charged to the camper's account and they will not be accepted into future camps until this is paid. Once camp has commenced no refunds will be made. Parents are expected to contact RBC if their child will not be attending camp after you have already registered.

Consents and Authority

Medical
I authorise RBC Staff, or appropriately trained volunteers to administer paracetamol or other ‘over the counter’ treatments to my child if they deem it appropriate. In the case of a medical emergency, I give RBC permission to seek medical help as required after first trying to contact me using the phone numbers I have provided. I will pay for any cost associated with this care.

Risk Discloser
I understand that activities at RBC have an element of risk associated with them.
I am happy for the child I am registering to participate in all activities at RBC. This child will also abide by the camp rules and I will pay for any wilful damage.

Promotions
I authorise RBC and OAC (a ministry partner) to send my child information about future Kids' Programmes and camps, contact them about youth groups, or send Bible Studies upon their request; and for any photos or videos taken during camp to be used for either of their advertising purposes.

Declaration
I declare that the details on this form are true and correct to the best of my knowledge.

Consent
By clicking "Submit" you indicate that you have read and understood our RBC Parent/ Guardian/Caregiver Notes and Terms of Agreement and Parent/Guardian Consent and Authority agreement.
I agree with the Terms and Conditions listed above *

Yes No
Should be Empty:

Riverbend Kids Camp Registration

Camper information Please provide all relevant details for the camper that will be attending camp.

Rooming Requests

Restricted Access

Medical, Behavioral and Dietary Information Please provide any relevant or helpful details on the camper

Parent/Guardian/Caregiver Details

Alternative Contact

Riverbend Terms and Conditions

Camper information
Please provide all relevant details for the camper that will be attending camp.

Medical, Behavioral and Dietary Information
Please provide any relevant or helpful details on the camper