• Gunditjmara September 2026 School Holiday Program Enrolment form

    Gunditjmara September 2026 School Holiday Program Enrolment form

  • Ngatta and welcome to the online Gunditjmara School Holiday program enrolment form.

    Please fill out all of the details below and click 'submit' at the end of this form.

    All children participating in this program must be of primary school age (5-12 years old).

    Forms MUST be submitted by Friday 18th September. If you are enrolling more than one child in the program, you must fill out multiple forms.

    Parents/cares are responsible for dropping off and picking up children at the indicated times and locations. Please call Gunditjmara if a later pickup time needs to be arranged.

    If your child becomes sick or is unwell, we expect the parent/carer/emergency contact to collect child in reasonable time frame. If children are to be picked up by other people, we need written/verbal permission by parent/carer.

    If your child has any additional needs filled out on the form, you will be contacted for a management plan if one has not been sent.

    DATE(S):

    Wednesday 23 September
    🍿 Lunch at McDonald’s followed by Forgotten Island at the Warrnambool Cinema.

    Monday 28 September
    🎳 Tenpin bowling – lunch first, followed by bowling at 1:00pm.
    drop off will be at the green 12pm, pick up at 2:30pm

    Wednesday 30 September
    🌳 Treetop adventure and ziplining day trip – bus transport is included. 8am depart 3pm pick up 

    Drop off and pickup times depend on day. Please see program flyer for more information.

    Paper forms available at 24 Hopkins Road. For any questions regarding the program, please contact Donna Chatfield on 5559 1234 or email donna.chatfield@gunditjmara.org.au.

     

    FORMS MUST BE COMPLETED BY FRIDAY 18th SEPTEMBER.

  • Do you or your child access our services at Gunditjmara Aboriginal Cooperative?*

  • This program is only available to Community who access our services. For any questions, please contact Donna Chatfield on 5559 1234. 

  • Please select below what dates you would like to enroll your child in (we will do the best we can to accommodate your selected dates). We kindly ask that if a child does not wish to participate in the event, please refrain from sending them. This will help ensure a smooth and enjoyable experience for everyone. Parents will need to be in attendance for higher needs children:*
  • Is a parent/carer planning to attend this event?:*

  • Child Details

  • Gender:*
  • Identifies as:*
  • Are there any Court/Intervention Order’s we should know about?*

  • Health details:

  • Immunisation record up to date?*
  • Are there any existing medical conditions to be aware of (disabilities, asthma, diabetes, heart condition, seizure of any type, ADHD etc)?*
  • Do you have any concerns about your child’s development or wellbeing (Speech, hearing, behaviour, etc.)?*
  • Does your child have any allergies?:*
  • Are there any medications to be aware of:*

  • All medications taken on activities or camps must be in a webster pack and given to Supervisor’s on arrival) please write name and dose time.

  • Dietary requirements:

  • Family details:

  • Emergency Contact #1

  • Emergency Contact #2

  • Last few questions:

  • Are you aware of other services available at Gunditjmara?:*
  • Do you need help with any of the above or have any questions? If yes, we will contact you.*
  • Do you give permission to take the child on excursions from Harris Street Reserve:*

  • Photo/video consent

  • I understand that it will not be for recording purposes only and may be reproduced in future publications.*

  • Final sign off:

  • Participant’s behaviour
    ‘I understand that in the event of my child’s misbehaviour or behaviour that poses a danger to themselves or others during the excursion or during the school holiday program, they may be sent home. I further understand that in such circumstances I will be informed and that any costs associated with their return may be my responsibility.’

    Participant illness
    ‘I understand that in the event excursion staff determine it is necessary for my child to be sent home early due to illness, any cost associated with their return may be my responsibility.’

    Cancellations or Alterations
    ‘I understand that GAC may need to cancel or alter excursion arrangements at short notice, for safety reasons or due to circumstances beyond the control of GAC, and while the Event Organiser will try to minimise inconvenience or financial losses to parents, these may be unavoidable.’

    Accident insurance and ambulance cover
    GAC does not provide accident insurance or ambulance cover. Parents may wish to obtain accident insurance from a commercial insurer and/or ambulance cover, depending on their health insurance arrangements and any other personal considerations. 

    Parent/Carer consent
    I have read all the above information provided by GAC in relation to the school holiday program excursions and programs, including any attached material.

    Your personal records are treated with the strictest confidentiality and the information provided will not be shared without your consent.

  • Please name and sign to confirm that you understand and agree with the information provided on this form:

  • I give permission for * to attend the September 2026 Gunditjmara School Holiday Program.

  • Date*
     / /
    2 digit day, 2 digit month, 4 digit year
  • Should be Empty: