Diabetes Camps Victoria EOI
Please fill out your details below to register your expression of interest.
About you
Parent or guardian full name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
Suburb
State
Post code
Parent or guardian mobile phone number
*
Please enter a valid phone number.
Format: 0000000000.
Parent or guardian other phone number
Please enter a valid phone number.
Format: 0000000000.
Parent or guardian email
*
About your child
Child's full name
*
First Name
Last Name
Child's date of birth
*
/
Day
/
Month
Year
Date
Child's gender
*
Male
Female
Non-binary
Other
NDSS number
*
Is your child of Aboriginal and/or Torres Strait Islander origin?
*
No
Yes - Aboriginal
Yes - Torres Strait Islander
Yes - Aboriginal & Torres Strait Islander
Prefer not to answer
What is the primary language spoken at home?
*
Date of diabetes diagnosis
*
-
Day
-
Month
Year
Date
Specialist name
*
Camp information
Please select which camp you wish to attend
Camp preference 1
*
Please Select
Family Camp November 2026 (5-8 year olds + one parent/guardian)
Camp preference 2
Please Select
Family Camp November 2026 (5-8 year olds + one parent/guardian)
Camp preference 3
Please Select
Family Camp November 2026 (5-8 year olds + one parent/guardian)
How old will your child be at the time of your preferred camp
*
Has your child previously attended a Diabetes Victoria camp?
*
Yes
No
If yes, what year was the previous camp?
What is your child's t-shirt size?
*
Please Select
Child Size 6
Child Size 8
Child Size 10
Child Size 12
Child Size 14
Adult Size S
Adult Size M
Adult Size L
Adult Size XL
Adult Size XXL
Adult Size XXXL
Is financial assistance required?
*
Yes
No
Please describe why you would like your child to attend Diabetes Camp
*
Please use this box for additional comments.
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