Kiilalaana Foundation & Footy Star Academy Mildura workshops
  • PERMISSION FORM

    PLEASE FILL OUT THE FORM BELOW FOR YOUR CHILD TO BE ABLE TO ATTEND THE 2023 Kiilalaana Foundation & Footy Star Academy Mildura Day workshops 17th & 18th January 2024
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  • STAFF & VOLUNTEERS ATTENDING

    SHANTELLE THOMPSON, SHYANNA VANDERMERWE, KATLIN MITCHELL, TAMMY BATH, & SAMANTHA KILLEN & Ben McGlyn
  • TRANSPORTATION

    Transport home provided and food for the day
  • REQUIREMENTS

    YOUR CHILD WILL BE REQUIRED TO PARTICIPATE IN THE PROGRAMS THAT HAVE BEEN SCHEDULED FOR THE CAMP. SHOW A GREAT LEVEL OF RESPECT AS WE HAVE BEEN INVITED OUT ON COUNTRY TO PARTICIPATE IN CULTURAL ACTIVITIES AND CULTURAL EXCHANGE AND WILL BE ELDERS AT THIS EVENT. YOUR CHILD IS REQUIRED TO RESPECT THAT THIS EVENT IS A SMOKE FREE, ALCOHOL FREE, DRUG FREE & VAPE FREE EVENNT
  • CONSENT 


    Media and Social Media release 

    I (parent/caregiver) hereby consent to the Kiilalaana Program and its Partners to take or have taken by others, photographs, digital images and/or audio and/or video footage (the images) of the young person named below, and to store the images, make copies of the images and publish the images in any form, in whole or
    in part, and distribute them in any medium including, but not limited to, print media, the Internet, Social Media, other multi-media uses or graphic representation, cinematography or video.
    I consent to the images being used by the Kiilalaana or provided to others for the following purposes only:
    • General news or promotion of the event on TV, Radio or in Newspapers, in trade and other journals and
    on websites and the internet.
    • The production of resources/programs that will assist development and growth of the Kiilalana mission,
    • Promoting and advertising the resulting educational products/resources,
    Kiilalaana and its Partners undertake not to use any images in a way that would cause embarrassment or misrepresent the intent of the student’s participation.
    I understand that neither I nor the student will be paid for giving this permission and I hereby waive any claim that I or we may have or may have had for remuneration, residuals, royalties or any other payment in respect of use of the images.
    I agree that Kiilalaana and its Partners shall not be bound to make any use of the images.

     

     

    Medical Release and Authorization

    As Parent and/or Guardian of the named young person, I hereby authorize the diagnosis and treatment by a qualified and licensed medical professional, of the young person, in the event of a medical emergency, which in the opinion of the attending medical professional, requires immediate attention to prevent further endangerment of the minor’s life, physical disfigurement, physical impairment, or other undue pain, suffering or discomfort, if delayed. Permission is hereby granted to the attending physician to proceed with any medical or minor surgical treatment, x-ray examination and immunizations for the named young person. In the event of an emergency arising out of serious illness, the need for major surgery, or significant accidental injury, I understand that every attempt will be made by the attending physician to contact me in the most expeditious way possible. This authorization is granted only after a reasonable effort has been made to reach me. Permission is also granted to the Kiilalaana. And its affiliates including Staff, Facilitators, Volunteers and Parents to provide the needed emergency treatment prior to the child’s admission to the medical facility. Release authorized on the dates and/or duration of the registered events. This release is authorized and executed of my own free will, with the sole purpose of authorizing medical treatment under emergency circumstances, for the protection of life and limb of the named minor child, in my absence.

     

     

    Informed Consent and Acknowledgement

    I hereby give my approval for my child’s participation in any and all activities prepared by Kiilalaana during their registration for the year of 2023 In exchange for the acceptance of said young person's participation in the Kiilalaana Tidda's Program. I assume all risk and hazards incidental to the conduct of the activities, and release, absolve and hold harmless Kiilalaana. And all its respective officers, agents, and representatives from any and all liability for injuries to said child arising out of traveling to, participating in, or returning from selected sessions. In case of injury to said child, I hereby waive all claims against Kiilalaana. Including all coaches and affiliates, all participants, sponsoring agencies, advertisers, and, if applicable, owners and lessors of premises used to conduct the event. There is a risk of being injured that is inherent in all activities, and events. Some of these injuries include, but are not limited to, the risk of fractures, paralysis, or death.

  • Cultiral Values and Cultural Protocals (behaviour expected of young people, staff and volunteers) 

    Kiilalaana Tidda Cultural protocals  – Summer Camp 2020
    Here at Kiilalaana Foundation we are dedicated to creating a brave, safe and inclusive space for all involved - Tiddas, families and staff a deadly camp experience. To accomplish this goal, mob are expected to behave appropriately and promote a safe, brave, inclusive, fun and healthy environment. Our goal is to promote relationship and character values of reciprocity, caring, honesty, respect, and responsibility in all aspects of our camp program. We ask that all mob and parents/guardians read this code together before arriving at camp.
    As a Tidda, I will:


    RESPECT
     Be respectful, cooperative and will contribute positively to the experience of fellow mob.

     Be careful and considerate that my actions will not hurt another mob feelings or hurt them physically, either intentionally or accidentally.
     Show respect to the Kiilalaana staff, and cooperate fully with their instructions. Follow directions at all times.
     Respect the rights and beliefs of others, and treat others with courtesy and consideration.
     Respect the property of others.
    PERSONAL SPACE AND PROPERTY - be mindful and respect others personal space 
     Be respectful of all others property and equipment/supplies.
     Never mark, deface or destroy camp or personal property.


    BEHAVIOR
     Conduct myself responsibly. I understand that horseplay, inappropriate touching, unwelcome teasing/bullying or any unkind behavior is not allowed and will not be tolerated.
     Communicate in an appropriate manner, which means I will not use foul language, gestures, or harsh words. I will not raise my voice, or use verbal threats of any kind.
     Refrain from deliberately causing bodily harm to the Tiddas or staff. I understand that pushing, kicking, hitting or fighting are not acceptable behavior. This behavior will not be tolerated and will be grounds for suspension/dismissal from the gathering program.


    SAFETY
     Tiddas need to pay attention to their surroundings and use care in all activities.
     Tiddas will adhere to all safety rules and regulations given for each activity that he/she participates in while at Gathering.

    be respectful of others and difference 


    GENERAL
     Tiddas must inform the Kiilalaana staff if they experiencing a problem with another Tidda/staff or other issues. If a staff member is not informed about a problem, they cannot assist the Tidda or stop the problem.
     We want all Tiddas to be included and to have FUN, but not at the expense of others.
     Tiddas are encouraged to participate in activities to the best of their ability.
     Violation of the Code of Conduct can be grounds for disciplinary actions including but not limited to automatic suspension/dismissal. 
     Weapons, look-alike weapons, or objects that may be used to threaten, intimidate, or harm others or to damage property may not be brought to Gathering.
     Phones are only permitted for set times, emergency use only or with approval from Kiilalaana staff. phones and all other electronics will be collected during set and agreed times to allow for full focus and engagement with others and activites.  and returned each day. If you need to get into contact with your child, please contact the Shantelle 0432 804 919 and the office staff will assist you in contacting your child

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  • EMERGENCIES

    If the above-named child requires any emergency medical treatment or procedures during the activities, I hereby consent to and authorize the above-named activity supervisor(s) to make any decision and take any action to arrange for such procedures or treatments in the discretion of the activity supervisor(s).

  • EMERGENCY CONTACT DETAILS 

    If, in the event of a medical or other emergency, I am unable to be reached by telephone at my home or work telephone numbers listed below, I authorize the activity supervisor(s) to attempt to contact me through the emergency contacts listed below.

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  • CONFIRMATION

    BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE. 

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