Sth Qld District HS Camp Leaders 2023

District High School Camp 2023 Leader Application

1st - 7th July 2023
Download a Leaders Job Description here

To be accepted as a leader, you are required to have your Pastor complete a Reference Form. If there is a conflict of interest, e.g. your parent is your pastor, please forward this to a Board Member of your church. Please forward this link to your Pastor/Board Member to complete the Reference online https://form.jotform.com/230442696307861

This form must be completed by the 26th May.

All information will be kept confidential.
Name*

First NameMiddle NameLast Name
Name Tag
No nicknames please
Shirt Size
Gender*
Date of birth*
Phone Number*
E-mail*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Church Name:*
Blue Card Number*
Blue Card Expiry/Application Date*
Do you have a First Aid Certificate?*
Emergency Contact:
Emergency Contact Name*

First NameLast Name
Phone Number*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Medical and other information
Medicare Number*
Are you currently taking any regular medicine?*
Name of Medication and Dose
Do you have any food allergies?*
Please select requirements

Lactose FreeGluten FreeSeafood FreeVegetarianEgg Free (Whole Egg OnlyNut Free
Details of allergies
Do you have any other allergies?*
Eg. Bandaids
Please list other allergies.
Name of Medication and Dose of other allergies.
Would you like to join the Worship Team?
What would you like to do on the worship team?
Have you any concerns or lack of skills/knowledge that may need to be addressed before camp? Please describe these:
Are you able to attend the compulsory leader training at the Gympie Wesleyan Methodist Church on 10th June from 9am till 2pm?*
This year leaders will be meeting on the 1st July, the day before camp, to prepare and set up. Leaders are required to be at Mapleton at 5pm.
Are you available for leaders meeting at Mapleton on Saturday the 1st July at 5pm?*
List any ministry you are/have been involved in at your local church?:*
What is your motivation to come to camp this year?*
What has God been doing in your life over the last year?:*

My Products

Leaders Registration$400.00AUD

This includes a camp shirt.

Donation to Sponsor a Camper $ Free AUD

Quantity

Credit Card Fee$7.00AUD

Enter coupon

Total $0.00AUD

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Is this your first or second year as a leader? *
If this is your first or second year as a leader, please CLICK HERE to read about what to expect on camp and what is expected of you as a leader. If you have any concerns please contact Adam Cousins, the Camp Director.
Leader Agreement*
Signature*
Print Name*
Today's Date*

DayMonthYear
Should be Empty:

District High School Camp 2023 Leader Application

Emergency Contact:

Medical and other information