Bosco Youth - Camp Registration Form

Which Camp are you registering for?
Contact Information
Parent/Guardian Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState

Post Code
Email
example@example.com
Phone Numbers
Home
Work
Child's Information
Child's Name

First NameLast Name
Gender
Date of Birth

DayMonthYear
2 digit day, 2 digit month, 4 digit yearDate
Age on Camp
What Year will you be entering in 2027
Medical Information
Medicare Number
Do you know the date of the last anti-tetanus injection?
Date of last anti-tetanus injection

DayMonthYear
If Unknown
Medical Conditions & Allergies
Medical conditions
Please list any medical conditions or allergies (e.g. asthma, anaphylaxis, epilepsy, diabetes, hay fever, medication sensitivity). Include severity and treatment if known.
Allergies
Other Information
Swimming Stage
Special Dietary Requirements?
Is there any other information which you feel the camp organisers should be aware of eg, sleep walker, phobias etc.?
Publicity and Advertising
How did you find out about this camp?
If you are a returning camper, how did you first find out about this camp?
Which Parish did you find out from?
Which School did you find out from?
What is the name of the friend that referred you to this camp?
Please write about how you found out about camp here:
Package Options

Your total will be automatically calculated based on today’s date and selected options.
Today's Date

DayMonthYear
2 digit day, 2 digit month, 4 digit yearFor testing you can change this to future dates - this field will be set to today's date not be visible in live version
Current Registration Cost
Includes Zip Line & Flat Water Rafting
Total Option Costs
Would you like to make a donation to assist other youth to attend camp?
Calculated Total Cost

Period	Dates	Price	Status
Super Early Bird (includes Rafting and Orienteering)	Ends 31 Aug	$300	Current rate
Early Bird (includes Rafting and Orienteering)	1 Sept – 31 Oct	$320
Standard (includes Rafting and Orienteering)	1 Nov – 15 Dec	$340
Late Registration (includes Rafting and Orienteering)	After 15 Dec	$360

Period	Dates	Price	Status
Early Bird (includes Rafting and Orienteering)	1 Sept – 31 Oct	$320	Current rate
Standard (includes Rafting and Orienteering)	1 Nov – 15 Dec	$340
Late Registration (includes Rafting and Orienteering)	After 15 Dec	$360

Period	Dates	Price	Status
Standard (includes Rafting and Orienteering)	1 Nov – 15 Dec	$340	Current rate
Late Registration (includes Rafting and Orienteering)	After 15 Dec	$360

Period	Dates	Price	Status
Late Registration (includes Rafting and Orienteering)	After 15 Dec	$360	Current rate

Summer Camp Registration Fee

AUDTotal Calculated Fee

Debit or Credit Card
First Name	Last Name
Credit Card Number	Security Code
Expiration Month	Expiration Year

Indemnity
Please read through the camper 'Code of Conduct' carefully with your child before proceeding to review and electronically sign the indemnity form.
- Bosco Youth Western Australia Inc.
  
  Camper Code of Conduct
  
  In the interest of providing an enjoyable camp experience for all, campers are bound by the following code of conduct. At the commencement of our Summer Camp, campers will be briefed about the rules and general code of conduct expected on camp and be asked to sign an agreement in line with the archdiocese safeguarding project.
  
  Serious breaches of this code of conduct or repetitive misdemeanours could result in parents being contacted and campers removed from the camp. In the unlikely event that this should occur, we are unable to offer a refund for those who only partake in a portion of the camp due to breaching the code.
  
  Boundaries and Safety
  
  External Boundaries
  - Campers are required to be within line of sight of leaders. To assist with this, campers are not to wander away from the campsite without supervision or go further than the island at the front of the campsite. Similarly, the back of the campsite is out of bounds unless participating in a scheduled activity.
  - The Gallery, Behind the gallery, Dorms and areas past the fire pit are also out of bounds.
  - When walking outside around the campsite (eg, bush walk etc), campers are required to wear closed in shoes unless told otherwise or walking to the waterhole for a swim.
  - Campers are required to always walk around in groups for added safety.
  - There are allocated swimming times each day. A Bronze Medallion person MUST go down with each group. These people will be made known at the commencement of camp.
  Kitchen and Medication
  - The Kitchen is out of bounds for hygiene reasons unless receiving medication or first aid. Unfortunately, campers are not allowed to have coffee or tea from the kitchen during camp.
  - Medication will be administered by the camp coordinator (Graham Maher) or other designated first aider. If any first aid is required, the camp coordinator or alternative first aider will administer and keep a log of all first aid applied.
  Fire Drill Procedures
  - Every person attending our camp (Campers and Leaders) will be allocated a fire drill number which will be used in the event of an emergency to quickly establish that everyone is present and accounted for. Occasionally Leaders may use this when moving away from the campsite eg during a bush walk.
  - In the event of a fire, campers will evacuate to the toilets which have been treated with a special fire retardant spray. Depending on the location, the camp caretaker may advise otherwise and evacuate the campsite to another location. In the unlikely event that this may occur, parents will be contacted.
  General Camp Rules and Code of Conduct
  - Girls are not permitted in Boys Dorms. Boys are not permitted in Girls Dorms
  - Boyfriend/Girlfriend relationships or intimate signs of affection (eg, kissing) cannot be displayed or be evident while on camp
  - Swearing is not permitted on camp
  - Dorm curtains open at all times unless changing/sleeping
  - Campers are required to ask permission from their table group leaders if they need to get something from the dorms during the day
  - Camp can get quite tiring, please respect others right to sleep at bed time. Any deliberate attempts to create noise or disturb others during this time may result in removal from their dorm with continuous cautions resulting in parents being called
  - Campers are not to get out of their dorms once lights have been turned off at night unless going to the toilet
  - Campers need to remain in dorms with curtains closed until music is played in the morning
  - Smoking/Vaping, illicit drugs & alcohol are not permitted on camp
  - Bosco Youth Western Australia Inc. are a Catholic Youth Organisation who have been operating for over 30 years within the Archdiocese of Perth. As such, campers are expected to uphold the teachings and ethos of the Catholic Church whilst on camp or any camp related activities thereafter.
  Breaches of discipline and disruptive behaviour (including bullying) will be dealt with in a fair manner. This includes pressuring another camper to perform an act which breaches the code in any way. Parents may be contacted and participants removed from the activity or camp for behaviours that are deemed to be disruptive or that put others at risk whether it be physically, emotionally or socially.
- I confirm that I have read and discussed the Code of Conduct with my child, and we both understand and agree to the expectations
- Indemnity
  
  I understand that while every reasonable precaution will be undertaken to ensure the protection of all campers, I hereby release Bosco Youth Western Australia Inc. camp organisers and volunteers, from any and all liability whatsoever for any accident, illness, loss or damage of personal property that may occur to my child and/or my child’s property during the camp activities that are connected with this application. I further indemnify the camp organisers against all loss, including legal expenses, connected with or arising from any claims or demands in relation to my child’s attendance at the event.
- I confirm that I have read and understood the Indemnity Information, and I agree to the expectations outlined
- Medical Treatment Consent
  
  I give permission for the Bosco Youth Western Australia Inc. camp organisers and volunteers to obtain emergency medical, hospital or ambulance assistance and/or treatment for my child as required. I acknowledge that I will be liable for any medical, hospital or ambulance expense incurred in my child’s treatment and I agree to meet any expenses attached thereto.
- I confirm that I have read and understood the Medial Treatment Consent, and I agree to the expectations outlined
- Privacy Declaration
  
  The event will be captured in photographs, video and audio. I understand that Bosco Youth Western Australia Inc. reserves the right to use this material for promotional purposes and on our website/social media sites unless otherwise stated in writin
- I consent to photos/video/audio of the event being used for promotional purposes, including website and social media:
- Transport Consent
  
  I give permission for my child to travel by bus to and from the Bosco Youth Western Australia Inc. Summer Camp at Nanga Bush Camp in Dwellingup from 4-8 January 2027. Although every precaution will be taken to ensure your child’s safety, I further agree that Bosco Youth Western Australia Inc., its staff and volunteers will not be held liable for any accident as a result of transporting your child
- I confirm that I have read and understood the Transport Consent, and I agree to the expectations outlined
- I give permission for my child to attend the Bosco Youth Summer Camp at Nanga Bush Camp in Dwellingup on 4-8 January 2027.
- Signature
- Should be Empty:

Contact Information

Child's Information

Medical Information

Other Information

Publicity and Advertising

Package Options

Summer Camp Registration Fee

Indemnity

Camper Code of Conduct

Boundaries and Safety