Caregiver 1 Information
This is the person the camper usually resides with.
Caregiver 2 Information
This is usually the spouse or partner of caregiver 1 OR another person the camper may reside with at times.
Emergency Contact Information
It is important we have a DIFFERENT third person who will be contacted only if we are unsuccessful in our attempts to contact the parents/caregivers listed above.
Child's Swimming Ability
Some of our camps may include swimming and/or water based activities. It is important our staff know the level of swimming ability to safely plan these activities.
We need to know if your child requires a special or restricted diet whilst at camp.
Dietary Requirements Surcharge
Due to the added cost and increased workload of catering for some dietary requirements (coeliac, GF, DF) we need to charge a surcharge for all campers that require a special menu. This is approximately $25.00
Please let us know how we can best manage any health issues.
Here are some examples of health notes:
Notification of Medications
Medication List Examples
Here are some examples of a medication list:
Nurofen Tablet (80mg):
- One tablet every 6 hours with food if required due to inflammation- John has a knee sprain that may get inflammed during exercise- No precautionsRitalin (20mg):- One 20mg tablet to be taken each day with breakfast & one 20mg tablet to be taken each day with lunch - Required for ADHD and general hyperactiveness - It is important that the medication must be taken at the correct times and if forgotten, DO NOT take at a different time
Notification of Behavioural Issues
Examples of a Behavioural Issues List:
Other Enrolment Information
Camp Fees and Discounts
There are several camp fee subsidies options available:
Important Information for OSCAR Subsidies
MSD also has an online tool to help families see what might be available to them in the way of financial assistance (including OSCAR subsidies) please visit https://check.msd.govt.nz/ to see if you might qualify for OSCAR subsidies for our camps. Ensure you select yes for the "Do you or your partner pay, or intend to pay, for this child to go to an OSCAR programme, for at least 3 hours a week?" question for each child you are intending to enrol.
Important Information for MoH Carer Support
Important Information for CYC Sponsorships
Important Information for Prison Fellowship
CYC Sponsorship Fund
Notification for Social Workers
Payment Terms for Camp Fees
Terms and Conditions of Attendance at CYC Waihola Camps:
We recommend you talk through any of these conditions that apply to the camper with them before they attend our camps to ensure they understand what is required of them.
These terms and conditions are subject to update at anytime - the latest terms and conditions can always be found on this page - http://cycwaihola.org.nz/wordpress/?page_id=4534
All enrolment information supplied is correct to the best of my knowledge
I acknowledge that this enrolment form information is used for the safe and effective operation of our camps and for possible further contact with the camper after camp.
I agree to the use of any photos/video containing the camper named on this form for publicity purposes without any remuneration.
Medical and Health Conditions
Unfortunately we cannot allow the camper to attend our camps if they have had (a full refund will apply if you let us know):
I authorise camp staff to:
Both New Zealand Ministry of Health guidelines and CYC Waihola strongly advise you, as a parent/caregiver, to immunise those children in your care before sending them to camp. It is strongly recommended that all campers attending our camps are fully immunised as per the national guidelines for immunisation in NZ. However we understand that choosing not to immunise may sometimes be an informed parental choice for some families and therefore we cannot enforce these recommendations. Therefore, please advise us if your child is not fully immunised for any reason, in case of a medical emergency.
CYC Waihola regularly has horses on-site and is also in a rural area where tetanus occurs, it is therefore strongly recommended that you check the enrolled camper has an up-to-date tetanus booster immunisation. Behavioural Conditions
I will not phone the camper named on this form during camp unless in an emergency. If the camper named on this form becomes unwell, disruptive or is not coping with being away from home, we will phone you on the supplied phone numbers.
I acknowledge that behaviour from the camper that disrupts the program, is harmful to others or destroys property will result in camper being sent home at my expense. Fees will not be refunded and camper may not be able to attend again.Camp Program Conditions
I acknowledge there will be Bible based talks presented throughout the camp at the campers level with the purpose of showing the relevance of the Bible today and to encourage the camper to develop a wholesome Christian life. Prayer will be said throughout the camp and before meals.
Camp programs often include outdoor activities that may have an element of high risk. CYC Waihola has strict Standard Operating Procedures (available on request) for managing these activities. Activities are run by trained CYC Waihola paid staff or other persons that have undergone comprehensive training in the activity.
Activities can be cancelled or postponed at the discretion of CYC Waihola staff at any time for the safety of the camper and CYC Waihola staff. These activities may not be suitable for persons with health or behavioural issues that could affect their ability to participate or follow the safety procedures. Any campers going outside the safety procedures and rules can result in serious harm. Activities in our camp programs may include but are not limited to: Air Rifles / Target Shooting, Archery, Archery Tag, Bubble Soccer, Go Carts, Horse Riding, Hunting (teenage camps only), Paint-ball, Tramping and Zip-line.
I give consent for the camper named on this form to take part in all camp activities, and for transportation of the camper named on this form to and from any off site activities.
Payment and Refund Terms
Unless a written arrangement is in place with the CYC Waihola office (or the camper is applying for a subsidy) :A $30.00 non-refundable deposit must be paid with all enrolments before the camper is enrolled in the camp. Camp fees must be paid in full before the camper will be admitted to camp
Terms and Conditions Last Updated: 10 November 2023
I, being the parent or legal guardian of the Camper, by pushing the submit button below, agree to the above Terms and Conditions of Attendance at CYC Waihola camps in full and give consent for the camper on this form to attend camp
PLEASE READ BEFORE SUBMITTING FORM