Camp Jabiru Practicum Application 2025

Thank you for your interest in being a practicum at Camp Jabiru 2025!

Important Dates

Practicum Lecture Day: 11th April 2025 (location: The Sensory Gym)

Camp Orientation: 12th April 2025 (location: Camp Yarramundi)

Camp Week: 13th-17th April 2025 (location: Camp Yarramundi)

Please note that camp is an overnight experience for all practicums even if you are assigned to a Day Camp Group. Some of the richest learning opportunities and clinical reasoning experiences happen after camp fire!
Practicum Application
Full Name*
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)
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Best Contact Number*
Please enter a valid phone number.
Alternative Contact Number
Please enter a valid phone number.
Place of Employment*
Liability Insurance Policy Provider*
Liability Insurance Policy Number*
University and Degrees Held
What continuing education courses have you taken? Please give the title, instructor, and date completed. *
Put "N/A" if there are none.
Working with Children Check number:*
Working with Children Check*

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Part of the practicum program involves building your reflective practice and clinical reasoning capacities. Here we ask you to begin some self-reflection by thinking about your goals for participation as a practicum. You will be given the opportunity to make the goals formal closer to the start of camp to support your learning and development. Think about why you want to be a practicum and what you hope to gain from this experience. Broadly, what are your personal goals for camp?*
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
List any special interests and/or skills you can contribute:*
Ex: music, sign language, etc. Put "N/A" if there are none.
Please upload a recent photo of yourself: *

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T-Shirt Size*

Health and Medical Information
Medicare Number*
Date of Birth*

MonthDayYear
Date
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. If you have other dietary needs you may write these in the "other" option, 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-FreeCasein-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, that may place me 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 need to be returned home for any reason I will cover any associated costs.

I am attending camp on this understanding.
Signature*

Clear
Date of Signature*

DayMonthYear
Date

Payment Information
The fee for attending camp as a practicum is $2500, which includes meals and lodging for 12th April 2025 through 17th April 2025 as well as your professional development experience (i.e., webinar of SpIRiT course, practicum lecture day and lectures throughout the camp week). Applications will be taken until positions are full. The amount of $2500 is payable with your application.

There are additional fees for staying overnight at camp on 11th April ($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 and wish to cancel or withdraw your application you will be charged as follows:
- Cancel before 1 January 2025--$25 Cancellation Fee
- Cancel between 1 January-1 March 2025--$100 Cancellation Fee
- Cancel after 1 March 2025--$500 Cancellation Fee
- Additional Cancellation Fee of $150 for the SpIRiT webinar course will be added if you cancel after you have received the link for the course (date TBA)
The practicum lecture day is on 11th April 2025. Camp orientation is on 12th April 2025. Meal service begins with lunch on the 12th. Would you like to stay overnight at camp on the 11th April 2025 (note that meals will not be provided)?*

YesNo
Would you like to be provided with a gluten-free diet while on camp?*

YesNo
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:

Practicum Application

Health and Medical Information

Dietary and Allergen Information

Swimming Ability

Emergency Contact Information

Payment Information