Camp Jabiru Student Application 2025

Camp Jabiru Student Application
Thank you for your interest in being a student at Camp Jabiru 2025! Please complete this application in full to be considered for placement.

Important Dates

Camp Orientation: 12th April 2025

Camp Week: 13th-17th April 2025
Applicant Details
Full Name*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email - please provide the email address that you check most frequently as you will be receiving a lot of important information regarding camp through this email:*
(example@example.com)
Best Contact Number*
Please enter a valid phone number.
Alternative Contact Number
Please enter a valid phone number.
Date of Birth*

DayMonthYear
Date
School Attending*
Year in School in 2025*
Briefly explain your interest in working as an OT in paediatrics:*
What do you hope to get out of the Camp Jabiru experience?*
List any special interests and/or skills you can contribute at camp:*
Ex: music, sign language, etc. Put "N/A" if there are none.
Which age range would you be most interested in working with? (Please note we can not guarantee your selection.)*

4-8 years old (day campers)8 years old (transition campers, one overnight)8-12 years old (overnight campers)12+ years old (Jabiru 2.0, apprentice campers)No preference
T-Shirt Size*
Please upload a recent photo of yourself: *

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Working with Children Check number:*
Please upload a copy of your current Working with Children Check: *

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Please review the student expectations:
Check here to confirm you have read and will comply with all student expectations (also available on The Sensory Gym® website) for participation at camp:*

Yes, I have read and will comply with the student expectations.

Health and Medical Information
Medicare Number*
Doctor's Name*
Doctor's Phone Number*
Please enter a valid phone number.
Year of Last Tetanus Injection*
Please enter a four-digit year.
Medications*
Put "N/A" if there are none.
Health Conditions*
Please include chronic conditions (physical and emotional/mental), injuries, asthma, and/or heart problems that may be relevant to your camp experience. Put "N/A" if there are none.
Activity Restrictions*
Please list anything that would restrict participation at camp (i.e., fear of heights, etc.). Put "N/A" if there are none.
Dietary and Allergen Information
Camp can accommodate the dietary needs listed below, with an additional $25 fee for gluten-free diets. If you have other dietary needs you may select "other," but you will need to supply your own food.

NOTE: Camp is nut free. You will not be able to bring any food products containing nuts, including non-dairy milks made from nut products.
Dietary Needs*

Gluten-Free (additional $25 charge)Casein-FreeVegetarianVeganHalalOther (I will bring what I need)None
Allergies *
Please list all allergies, including to foods, medications/drugs, insects, plants, etc. Please note if any of these allergies are anaphylactic. Put "N/A" if there are none.
Swimming Ability
Please rate swimming ability based on the following:

Unable - nothing more than a dog paddle

Poor - basic strokes, only limited strokes beyond domestic swimming pool

Good - strong swimmer, able to swim confidently in a variety of water conditions

Excellent - very strong and confident, could swim 50 meters fully clothed
Swimming Ability*
Emergency Contact Information
Full Name*
Relationship to Person Attending Camp*
Emergency Contact Phone Number*
Please enter a valid phone number.
YMCA Medical Consent

I understand that YMCA NSW and its instructors will take reasonable care for the welfare and safety of those attending the camp but are not responsible for any accident or sickness otherwise occurring. I acknowledge that going on camp may involve participation in activities of a hazardous nature, though YMCA NSW and its instructors will take reasonable care to minimise risk to participants.

I have detailed herein any disabilities or susceptibilities affecting me/my child, that may place me/my child at greater than normal risk. I authorise YMCA NSW and its instructors to obtain medical assistance and ambulance transportation in the event of illness or injury as they think necessary and authorise qualified medical practitioners to administer anaesthetic, blood transfusions, or any other procedures deemed necessary. I also agree to pay all the cost of any expenses incurred as a result of such medical assistance and ambulance transportation. I acknowledge that I am able to obtain private insurance cover in respect of any accidents or sickness at the camp. Should I/my child need to be returned home for any reason I will cover any associated costs.

I am/my child is attending camp on this understanding.
Signature*

Clear
Date of Signature*

DayMonthYear
Date

Payment Information
The fee for attending camp as a student is $200, which includes meals and lodging for 12th April 2025 through 17th April 2025. Applications will be taken until positions are full. The amount of $200 is payable with your application.

There are additional fees for staying overnight before camp ($55) and for gluten-free meals at camp ($25). Please select the options that apply to you and calculate the total fee when submitting payment.

All payments will be refunded immediately if a place is not made available to you.

If you are accepted into camp and cancel your participation, the following cancellation fees will apply:

Cancellation prior to January 1, 2025 - $25 cancellation fee

Cancellation between January 1 - March 1, 2025 - $50 cancellation fee

Cancellation any time after March 1, 2025 - $150 cancellation fee
Would you like to stay overnight at camp on the 11th April 2025? Note that meals will not be provided. Meal service starts with lunch on the 12th.*

Yes - add $55 to your total paymentNo
Would you like to be provided with a gluten-free diet while on camp?*

Yes - add $25 to your total paymentNo
You may pay by credit card or through direct deposit. If paying by credit card, we will contact you to provide these details upon receipt of your application. Please note that a 1.155% surcharge will be applied to credit card payments.

If paying by direct deposit please deposit the appropriate funds when you submit this application. Deposit funds to:

The Sensory Gym
St. George Bank Richmond
BSB 112 879
Account 491 763 765

Please use your name as the reference.
Please select your payment method:*

Credit CardDirect Deposit
Should be Empty:

Camp Jabiru Student Application

Applicant Details

Health and Medical Information

Dietary and Allergen Information

Swimming Ability

Emergency Contact Information

Payment Information