Redland Bay Camp APRIL2025

Redland Bay Camp (CAMP FULL 🤷🏼‍♂️)

Teen Adventure Retreat!
Tues 8th - Thurs 10th April

11:00am arrival at Campsite, 12:00pm Departure

Join us for a 3 day, 2 night adventure at Brisbane's bayside! Enjoy exciting games and activities, stargazing and marshmallows, while making meaningful connections with other Young Carers.

Registrations essential, transport NOT provided. All food & drinks supplied.

Open to ages 13-17

Young Carers may only be accepted into one program per School Holiday period, and one camp annually.
Young Carer Details
Young Carer Name*

First NameLast Name
Preferred Name
Young Carer Birthdate*

DayMonthYear
Date
Record Type ID
Parent / Guardian Mobile Phone*
Please enter a valid phone number.
Parent/Guardian Details

This will be the primary emergency contact
Parent/Guardian Name
Parent/Guardian Relationship
Parent / Guardian Email*
example@example.com
Parent/Guardian Alternative Email
Optional
Emergency Contact Details

This must be different from the parent/guardian listed above and will only be contacted if parent/guardian listed above is unavailable.
Emergency Contact Name
Emergency Contact Relationship
Emergency contact phone
Please enter a valid phone number.
Medical & Wellbeing Information

All the information in this form will be kept confidential for relevant Little Dreamers and other program staff.
Have you had any recent issues or incidents that would be helpful for us to be aware of?

YesNo
If YES please give details:
(E.g. a recent loss or serious illness within your family or wider network, traumatic experience, family disruption, bullying)
Has your behaviour ever been an issue for yourself or those around you?

YesNo
If YES please give details:
E.g. issues with authority, issues with people close to you, acting out/breaking rules and getting into trouble, trouble with police/legal problems)
Is there any other information we need to know about your mental health or wellbeing prior to attending this program?
Medication

All medication listed below must be handed over to the medic pre-camp departure. All medication (including ‘As needed’ (PRN) medication) must be in a snaplock bag clearly named with all medication appropriately labelled.

‘As Needed’ (PRN) medications include any medication used circumstantially such as in response to the onset of a headache or asthma attack. Examples include: headache tablets, hayfever tablets.

Little Dreamers will use this information if your child is involved in a medical emergency.

All information is held in confidence. This medical form must be current when the program is being held.
Do you have any medical conditions Little Dreamers needs to be aware of?

YesNo
If YES please give details:
Will you need to take medications during the camp?

YesNo
Please provide comprehensive information:
For each needed medication, please state the name, dosage (ml, mg etc.) What is this medication prescribed for? How is the medication to be administered?(ie. before or after a meal, 30 minutes before bed)
AUTHORISATION: The above information is correct and up to date and I authorise Little Dreamers personnel to administer the above medications as indicated.*

YES
Do you have any prior injuries or conditions that we should be aware of that may prevent you from participating in physical activities?**

YesNo
If YES please give details:
Do you have any food intolerances, allergies or requirements that we should be aware of*

YesNo
If YES please give details:
Is the applicant registered with the Carer Gateway?*

YesNo
Please note, your booking is not confirmed. This is an application only. You will be contacted once your program funding has been confirmed.
Please note, your booking is not confirmed. You will be contacted once your program funding has been confirmed. By submitting this application you consent to Little Dreamers sharing your information with the Carer Gateway.
Do you have ambulance cover?*

YesNo
IF NO, please refer to the Event Waiver: (2) Medical Treatment for more information
Your Say
What are three things you are hoping to get out of attending this retreat? *
Program Options
Opportunity Name
Opportunity Close Date

DayMonthYear
Date
Terms & Conditions

You need to agree with the Event Waiver conditions outlined here and the Cancellation Policy outlined here in order to attend this event.

The Photo & Media consent details are outlined here.
Photo and media consent
Please read and confirm the following:
- I am available on the dates of the retreat
- I am able to spend up to 2 nights away from home unsupported
- I am able to sleep in a room with other same sex young carers
- I am able to communicate to a retreat leader when I am feeling sad or unwell
- I have strategies to manage any challenges that may arise during camp
- I am willing to step outside my comfort zone & try new things
- I am able to be transported to the camp/retreat location & be picked up (if needed)
I confirm that I have read and understood the above and consent to the Waiver and other terms provided.*

Yes
Who is providing consent?*

I am a Young Carer consenting on my own behalf (16 years and older only)I am a Parent/Guardian consenting on behalf of my child
Young Carer Name
Young Carer Signature

Clear
Parent Guardian Name
Parent Guardian Signature

Clear
Application Date

DayMonthYear
Date
Should be Empty:

Redland Bay Camp (CAMP FULL 🤷🏼‍♂️)

Young Carer Details

Parent/Guardian Details

Emergency Contact Details

Medical & Wellbeing Information

Medication

Your Say

Program Options

Terms & Conditions

Please read and confirm the following: