25th National Junior Muslim Youth Camp (Ages 12-15yrs)
Participant enrolment to be completed by a parent/guardian aged 18 and over.
Camp Location
Camp Coonawarra Glenaladale
Camp Dates
From the 28th of September to 2nd of October 2026
Camp Cost
$399
Participant Information
Personal Information about the Participant applying
Full Name
*
First Name
Last Name
Date of Birth
*
-
Day
-
Month
Year
2 digit day, 2 digit month, 4 digit year
Date
Gender
*
Male
Female
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Mobile Number
*
Participant Mobile Number (or the best contactable number)
Format: 0000 000 000.
Email
*
Participant Email (or guardians email)
School Year Level
*
The participant's current school year level
Jumper Size
*
Please Select
XXS
XS
S
M
L
XL
XXL
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Medical Details
Please answer all medical questions. It is essential that staff are aware of any medical conditions the participant may have to best cater for them.
Does the Participant have any diagnosed Medical Conditions? (e.g., Asthma)
*
Yes
No
If Yes, please describe the Medical Condition
*
If you are diagnosed with Asthma or Anaphylaxis you are required to bring your medication to the camp. Please note any required prescription medicine if required
Does the Participant have any behavioural or learning challenges?
*
Yes
No
If Yes, please provide a description
*
This is to inform team leaders and staff to ensure your child's needs are best accommodated for.
Does the Participant have any special dietary requirements?
*
Yes
No
If Yes, please provide a description
*
All of our food is 100% Halal
Medicare Number
*
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Emergency Contact
Information about a parent/guardian/next of kin for the student (must be aged 18 years and older)
Full Name
*
First Name
Last Name
Relationship to Participant
*
Please Select
Father
Mother
Grandparent
Sibling
Guardian
Other
Are the contact details (Email, Address & Mobile Number) the same as the ?
*
Yes
No
Mobile Number
*
Please enter a valid phone number.
Format: 0000 000 000.
Phone Number
Please enter a valid phone number.
Format: (00) 0000-0000.
Email
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Photography & Film Permission
For purposes of documentation, marketing, and evaluation, it is necessary to take photos/videos of students. Images may be used for printed publications, online and social media activities.
Photography & Filming Permission
*
I give photo / film consent
I do not give photo / film consent
Participant Questions
Have you previously attended a YMA Camp?
*
Yes
No
Why would you like to attend this camp?
*
How did you hear about the camp?
*
Please Select
Call from the YMA Team
Instagram
Facebook
Email
Friends
Saturday Madrasah
Sunday Madrasah
Word of Mouth
School brochure
Poster
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Declaration
This section is to be completed by a parent / legal guardian
By ticking the box below you are agreeing that the all of the above information is correct and you will inform YMA of any changes to details.
*
I agree that the above information is correct
Comments
Any additional information you would like to provide.
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Fees
Payment of fees is a requirement to secure your attendance.
Please choose from one of the following payment options
*
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( X )
Full Payment
$399.00 AUD
$
399.00
AUD
for each
year
3 x Fortnightly Installments
$133.00 AUD
$
133.00
AUD
for each
two weeks
4 x Fortnightly Installments
$99.75 AUD
$
99.75
AUD
for each
two weeks
Cash Payment
With Admin approval only
Free
$
Free
AUD
for each
year
Email
Debit or Credit Card
First Name
Last Name
Credit Card Number
Security Code
Expiration Month
January
February
March
April
May
June
July
August
September
October
November
December
Expiration Month
Expiration Year
2026
2027
2028
2029
2030
2031
2032
2033
2034
2035
2036
2037
2038
2039
2040
2041
2042
2043
2044
2045
Expiration Year
Submit
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