Dare 2B Deadly On Country Camp form

Dare 2B Deadly Camp

Expression of Interest form
As a parent or carer, for a young person to find out more about the camp and possibly attend.As a school, organisation or community member, to support or participate in the camp.

I am interested in the Dare 2B Deadly On-Country Camp for a young person ...
Young person's name*

First NameLast Name
School
Birth Date*

MonthDayYear
Gender*
Additional young people I would like to register: name, age and school (if school is different from above)
I am the parent or carer for this young person. My details are ...
Parent or carer's name*

First NameLast Name
Town*

Street Address

Street Address Line 2

TownState / Province

Postcode
E-mail*
example@example.com
Phone Number*
Format: (000) 000-0000.
Additional Comments or Information

I am interested in myself, school or organisation supporting this event or helping to organise it.
Name*

First NameLast Name
Organisation or school (if applicable)
Activity or interest
E-mail*
example@example.com
Phone Number*
Format: (000) 000-0000.
Additional Comments or Information

You haven't filled in any details! Please choose an alternative and fill in the form if you want to register a young person or help the event to happen. Click Back below.

Thanks. Please press Submit now to complete your Expression of Interest. We will send you occasional emails as the program develops.

If you have any enquiries or want to discuss this program, please contact info@blakartscollective.com.au.
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Dare 2B Deadly Camp