Sth Qld District Kids 2026

Sth Qld District Kids Camp

Friday 24th - Sunday 26th April 2026
How many campers?*
Camper #1 Name*

First NameLast Name
Gender*
Date of Birth*

DayMonthYear
Year Level*
Medicare Number*
Is Camper #1 on any medication?*
Name of Medication and Dose
Does Camper #1 have any Food Allergies?*
Please select

Lactose FreeGluten FreeSeafood FreeVegetarianEgg Free (Whole Egg Only)Nut FreeOther
Details of allergies
Does Camper #1 have any other allergies?*
Eg. Bandaids
Please list other allergies.
Name of Medication and Dose for other allergies
Camper #1 Shirt Size*
Camper #1 Swimming Ability*

Camper #2 Name

First NameLast Name
Gender
Date of Birth

DayMonthYear
Medicare Number
Year Level
Is Camper #2 on any medication?*
Name of Medication and Dose
Does Camper #2 have any food allergies? *
Please select

Lactose FreeGluten FreeSeafood FreeVegetarianEgg Free (Whole Egg Only)Nut FreeOther
Details of allergies
Does Camper #2 have any other allergies? *
Eg. Bandaids
Please list other allergies
Name of Medication and Dose for other allergies
Camper #2 Shirt Size*
Camper #2 Swimming Ability*

Camper #3 Name

First NameLast Name
Gender
Date of Birth

DayMonthYear
Medicare Number
Year Level
Is Camper #3 on any medication?*
Name of Medication and Dose
Does Camper #3 have any food allergies?*
Please select

Lactose FreeGluten FreeSeafood FreeVegetarianEgg Free (Whole Egg Only)Nut FreeOther
Details of allergies
Does Camper #3 have any other allergies?*
Eg. Bandaids
Please list other allergies
Name of Medication and dose for other allergies.
Camper #3 Shirt Size*
Camper #3 Swimming Ability*

Camper #4 Name

First NameLast Name
Gender
Date of Birth

DayMonthYear
Medicare Number
Year Level
Is Camper #4 on any medication?*
Name of Medication and Dose
Does Camper #4 have any food allergies?*
Please select

Lactose FreeGluten FreeSeafood FreeVegetarianEgg Free (Whole Egg Only)Nut FreeOther
Details of allergies
Does Camper #4 have any other allergies?*
Eg. Bandaids
Please list other allergies
Name of Medication and dose for other allergies.
Camper #4 Shirt Size*
Camper #4 Swimming Ability*

Camper #5 Name

First NameLast Name
Gender
Date of Birth

DayMonthYear
Medicare Number
Year Level
Is Camper #5 on any medication?*
Name of Medication and Dose
Does Camper #5 have any food allergies?*
Please select

Lactose FreeGluten FreeSeafood FreeVegetarianEgg Free (Whole Egg Only)Nut FreeOther
Details of allergies
Does Camper #5 have any other allergies?*
Eg. Bandaids
Please list other allergies
Name of Medication and dose for other allergies.
Camper #5 Shirt Size*
Camper #5 Swimming Ability*

Family Information
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
E-mail Address*
Parents email address
Which church are you connected with? *
Emergency Contact Information
Emergency Contact Name*

First NameLast Name
Emergency Contact Phone Number*
Address*

Street Address

Street Address Line 2

City

Postal / Zip Code
Relationship to camper*
Name of person completing this form?*

First NameLast Name
Please list the names of other campers that your child/ren would like to be in the same dorm as.
While we do our best to arrange this, we can't guarantee this request.
Is there any other information we should know about your child/ren?
Medical Information

Please Note: All drugs must be in their original containers with the child's name and dosage clearly marked. Tablets/medicine in non original containers cannot be accepted at camp.

All drugs MUST be handed in at the start of camp to the Camp Nurse. There are to be no drugs including headache tablets kept in dormitories due to the risk of misuse.
Indemnity Declaration*
PAYMENT

Full Payment is due 3rd of April. Feel free to pay in installments.

Be sure to include the appropriate description.

Please make payment via direct debit to:

Name: Wesleyan Methodist Church South Queensland District

BSB: 034-083

ACC: 120854

Description: KCAMP 26 (SURNAME of CAMPER)
Should be Empty: