Summer 2018 Kids Camp Volunteer Registration

Summer 2018 Kids Camp Volunteer Registration
Role*
(Leader, LIT, Area Head, AV Crew, Camp Parent, Speaker, Other)
Note: minimum age for LITs is 14.
Personal Information
Name*

First NameLast Name
Gender*

MaleFemale
Date of Birth*

DayMonthYear
Age*
(At time of Camp)
School Year Level
(If applicable)
Current church you attend
If applicable
Address*

Street Address

Street Address Line 2

SuburbCity or Town

Post CodeCountry
Home Phone Number*

Area CodePhone Number
Cellphone Number*

Area CodePhone Number
Contact E-mail*
Preferred Co-Leader?
Would you like to be a part of the music team?*

YesNo
If so, what instruments do you play?
Parent / Guardian Contact Information
Parent Name
D.O.B*

DayMonthYear
Home Phone Number

Area CodePhone Number
Cellphone Number

Area CodePhone Number
Medical & Dietary Information
Specify any conditions that may effect you during camp and require special care:
Medical conditions
Medication - Specify any medication that you may be taking during camp:

(Medication, including paracetamol, MUST be handed in at the start of camp)
Medication
Dietary Requirements - vegetarian, dairy-free, nut-free, gluten-free, other food allergies:

(This must be entered EVERY camp)
Dietary
Are you allowed to be administered Paracetamol?*

YesNo
Last tetanus shot Date:
Name of Emergency Contact*
They must be from a different household than the Parent/Guardian listed above. Alternative Contact must be available 24 hours a day during a camp. In an emergency, we will contact this person if unsuccessful in our attempts to contact the Parent or Guardian.
Relationship to Volunteer*
Phone Number

Area CodePhone Number
Work Phone Number

Area CodePhone Number
Cellphone Number*

Area CodePhone Number
Anything else we should be aware of?
Transport Information
Do you require to be picked up BEFORE CAMP from an external Bus Service at the Matamata iSite?
Bus Pick Up?*

YesNo
Bus Service and Time
Please make sure you inform Toby (toby.young@totarasprings.org.nz) at least one week before camp to make sure we can pick you up at the correct time.
Pickup Details
Name
Phone Number

Area CodePhone Number
NOTE: Please ensure you are picked up by 2pm at the latest, any further questions or arrangements, email or call Toby 07 888 4700 ext 224 toby.young@totarasprings.org.nz directly. BEFORE camp starts.

If you would like to take the Totara Springs Bus home, please EMAIL and ORGANIZE this with Nicky - nicky.houghton@totarasprings.org.nz
Reference Name*
Reference Phone Number:*

Area CodePhone Number
Reference Email
Have you competed the following in the past 2 years?
Application Form*

YesNoNot Sure
Phone Reference

YesNo
Written Reference Form*

YesNoLiT - Not Needed
Police Check*

YesNoNot sure16 or under
Click here to fill out a Volunteer Application Form

Click here to fill out a LIT Application Form

Click here to download a Written Reference Form

Click here to download a Police Check Form
Accompanying Family Members
Do you have any family coming with you?*

YesNo
Check all that apply

SpouseChild age 17yrs+Child 13-16yrsChild 12yrs and under
Anybody over 16yrs requires a Police Check.
Your child can be a leader (15+) or an LiT (Jkids Camp 13-16yrs) Kids Camp (14-16yrs)

Click here to sign them up!
Your Child can come as a camper for free (Kids Camp 8-12yrs) (Jkids Camp 6-8yrs)

Click here to sign them up! Otherwise they can just float round camp with you.
Please enter the names of ALL family members that will be attending camp.
Name #1

First NameLast Name
Gender

MaleFemale
Date of Birth

DayMonthYear
Do they have any dietary requirements?

YesNo
Dietary Requirements - vegetarian, dairy-free, nut-free, gluten-free, other food allergies:

(This must be entered EVERY camp)
Dietary
*If over 16yrs* Have they completed a police check for TSCC in the past 3 years?

YesNoN/A
Add another family member?

Yes
Name #2

First NameLast Name
Gender

MaleFemale
Date of Birth

DayMonthYear
Do they have any dietary requirements?

YesNo
Dietary Requirements - vegetarian, dairy-free, nut-free, gluten-free, other food allergies:

(This must be entered EVERY camp)
Dietary
*If over 16yrs* Have they completed a police check for TSCC in the past 3 years?

YesNoN/A
Add another family member?

Yes
Name #3

First NameLast Name
Gender

MaleFemale
Date of Birth

DayMonthYear
Do they have any dietary requirements?

YesNo
Dietary Requirements - vegetarian, dairy-free, nut-free, gluten-free, other food allergies:

(This must be entered EVERY camp)
Dietary
*If over 16yrs* Have they completed a police check for TSCC in the past 3 years?

YesNoN/A
Add another family member?

Yes
Name #4

First NameLast Name
Gender

MaleFemale
Date of Birth

DayMonthYear
Do they have any dietary requirements?

YesNo
Dietary Requirements - vegetarian, dairy-free, nut-free, gluten-free, other food allergies:

(This must be entered EVERY camp)
Dietary
*If over 16yrs* Have they completed a police check for TSCC in the past 3 years?

YesNoN/A
Add another family member?

Yes
Name #5

First NameLast Name
Gender

MaleFemale
Date of Birth

DayMonthYear
Do they have any dietary requirements?

YesNo
Dietary Requirements - vegetarian, dairy-free, nut-free, gluten-free, other food allergies:

(This must be entered EVERY camp)
Dietary
*If over 16yrs* Have they completed a police check for TSCC in the past 3 years?

YesNoN/A
Add another family member?

Yes
Name #6

First NameLast Name
Gender

MaleFemale
Date of Birth

DayMonthYear
Do they have any dietary requirements?

YesNo
Dietary Requirements - vegetarian, dairy-free, nut-free, gluten-free, other food allergies:

(This must be entered EVERY camp)
Dietary
*If over 16yrs* Have they completed a police check for TSCC in the past 3 years?

YesNoN/A
By clicking "Submit" you are giving permission for all information collected on this form to be used by Totara Springs Christian Centre for administration, follow-up and emergencies; and that it may be shared with government agencies for statistical purposes or where safety is a concern with Oranga Tamariki, Ministry for Vulnerable People or the police.

You are also giving consent for the email address provided in the Personal Contact E-mail field to be added to the Totara Springs Christian Centre's Camp Email List.

Lastly, if you do attend the camp, you are also giving consent for any photos or videos taken during camp to be used for advertising purposes.
Should be Empty:

Summer 2018 Kids Camp Volunteer Registration

Personal Information

Parent / Guardian Contact Information

Medical & Dietary Information

Transport Information

Accompanying Family Members