Summercamp 2027

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PARENT’S / CAREGIVER’S DETAILS

This online form must be completed by the parent / caregiver and will act as a permission slip for your child/ren.

Your name:*

First Last

Your email:*

Your mobile number:*

Your relationship to child/ren:

Father

Mother

Other

Medicare number:*

Medicare expiry date:*

EMERGENCY CONTACT DETAILS

Emergency contact name (if you are unavailable):*

First Last

Emergency contact mobile number:*

Emergency contact relationship to child/ren:

Father

Mother

Other

How many campers are you booking?

Earlybird rate per child= $550. The earlybird rate will close on 7 October. (Full rate = $600 per child). We try to keep the cost as low as we can (while still breaking even). If the cost is an issue, please don't let it stop your child coming. Feel completely free to get in touch with Craig (craig.foster@st-thomas.org.au) and we will try to arrange something that works.

CHILD 1

Camper's name:*

First Last

Date of birth:*

High school in 2027:*

School year in 2027:*

Preferred tribe

This is for the glorious Summercamp Cup championship. If your child has come to Summercamp before and has a tribe they feel a particular connection to, you can select that here. Otherwise just select N/A and we'll place them in a tribe. N.B. There are no guarantees here - we reserve the right to place a child in whichever tribe we think is best for Summercamp Cup 🙂

North (Red)

South (Blue)

East (Yellow)

West (Green)

N/A

Is this child able to swim 50m unassisted?*

Yes

Would you like to order a Summercamp T-shirt for this child? ($30)*

Yes please

No thanks

Summercamp T-shirt size ($30)

The two measurements in brackets are (half chest measurement // length measurement).

Half chest measurement: To figure this out, grab a t-shirt that you own and like the fit across the chest, then lay it flat on a table and measure armpit to armpit across the chest. That measurement is the half chest measurement.

Length measurement: To figure this measurement out, grab a t-shirt that you own and like the length of (as in, how far down your body it goes), lay it flat on a table with the back of the shirt facing up, then measure from the top (the back of the neck) down to the bottom of the shirt. This is the length measurement.

S (47cm // 70cm)

M (52cm // 74cm)

L (56.5cm // 77.5cm)

XL (61cm // 81cm)

2XL (64cm // 84cm)

3XL (68cm // 87cm)

Dietary requirements:

Please write any dietary requirements here. N.B. While the campsite can cater for diets that exclude things like gluten or nuts, they unfortunately cannot cater for diets that require no traces (e.g. no traces of nuts). If you require a 'no traces' diet, parents will need to supply food for their child/ren.

Medical information:

Please note any medical information we need to know here.

If your child is taking any medication, please note the details here and indicate how you would like it administered (e.g. the first-aid leader holds on to the medication and helps the camper administer it throughout the camp, or the camper holds on to the medication and self-administers with the first-aid leader checking in).

If your child is anaphylactic, please note that here and send their anaphylaxis plan to emma.whittaker@st-thomas.org.au

Additional information we should know:

CHILD 2

Camper's name:*

First Last

Date of birth:*

High school in 2027:*

School year in 2027:*

Preferred tribe

North (Red)

South (Blue)

East (Yellow)

West (Green)

N/A

Is this child able to swim 50m unassisted?*

Yes

Would you like to order a Summercamp T-shirt for this child? ($30)

Yes please

No thanks

Summercamp T-shirt size ($30)

The two measurements in brackets are (half chest measurement // length measurement).

S (47cm // 70cm)

M (52cm // 74cm)

L (56.5cm // 77.5cm)

XL (61cm // 81cm)

2XL (64cm // 84cm)

3XL (68cm // 87cm)

Dietary requirements:

Medical information:

Please note any medical information we need to know here.

If your child is anaphylactic, please note that here and send their anaphylaxis plan to emma.whittaker@st-thomas.org.au

Additional information we should know:

CHILD 3

Camper's name:*

First Last

Date of birth:*

High school in 2027:*

School year in 2027:*

Preferred tribe

North (Red)

South (Blue)

East (Yellow)

West (Green)

N/A

Is this child able to swim 50m unassisted?*

Yes

Would you like to order a Summercamp T-shirt for this child? ($30)

Yes please

No thanks

Summercamp T-shirt size ($30)

The two measurements in brackets are (half chest measurement // length measurement).

S (47cm // 70cm)

M (52cm // 74cm)

L (56.5cm // 77.5cm)

XL (61cm // 81cm)

2XL (64cm // 84cm)

3XL (68cm // 87cm)

Dietary requirements:

Medical information:

Please note any medical information we need to know here.

If your child is anaphylactic, please note that here and send their anaphylaxis plan to emma.whittaker@st-thomas.org.au

Additional information we should know:

CHILD 4

Camper's name:*

First Last

Date of birth:*

High school in 2027:*

School year in 2027:*

Preferred tribe

North (Red)

South (Blue)

East (Yellow)

West (Green)

N/A

Is this child able to swim 50m unassisted?*

Yes

Would you like to order a Summercamp T-shirt for this child? ($30)

Yes please

No thanks

Summercamp T-shirt size ($30)

The two measurements in brackets are (half chest measurement // length measurement).

S (47cm // 70cm)

M (52cm // 74cm)

L (56.5cm // 77.5cm)

XL (61cm // 81cm)

2XL (64cm // 84cm)

3XL (68cm // 87cm)

Dietary requirements:

Medical information:

Please note any medical information we need to know here.

If your child is anaphylactic, please note that here and send their anaphylaxis plan to emma.whittaker@st-thomas.org.au

Additional information we should know:

PERMISSIONS FOR SUMMERCAMP27

I give permission for the first-aid leader to give my child/ren to paracetamol (if required).*

If you answer no, we will need to call you for permission if your child requires paracetamol at some point.

Yes

I give permission for my child/ren to be filmed and photographed at Lights activities for the purpose of promoting Lights (promotion could include posting photos / videos to the Lights website / social media or playing videos at Lights events or church services)*

Yes

I give permission for my child/ren to be driven by a Lights leader (with at least green Ps) when there are at least 3 people in the car (members or leaders) and one of those people is of the same gender as my child/ren.*

Yes

In case of a medical emergency, I give permission to the doctor chosen by the supervising leaders to secure proper treatment and/or hospitalisation, injection, anaesthetic or surgery for my child/ren. I understand every effort will be made to contact me prior to instituting such procedures.*

Yes

I give permission for my child/ren to watch G or PG movies*

Yes

I understand that Summercamp is a mobile free camp and so I will make sure my child/ren does not take a mobile phone. If my child/ren is unable to sleep without music, I will make sure they have a non-phone MP3 player for them to take. N.B. The camp directors and the site manager will be contactable by phone if you need to speak with your child/ren. If there is another reason your child/ren needs their phone, please get in touch with Craig (craig.foster@st-thomas.org.au).*

Yes

I give full permission for the above mentioned child/ren to participate fully in all activities associated with Summercamp26. While every precaution shall be taken to ensure the good welfare and protection of the applicant child/ren, St Thomas' Anglican Church or any person acting on their behalf are hereby released from any and all liability in the event of any accident or misfortune that may occur to the applicant child/ren or damage or loss to their property.*

Yes

Total

Please click 'Proceed to Payment' even if the Total is $0. This will ensure all your details are captured. If your total is $0 you can close the window after clicking 'Proceed to Payment'. If you have ordered T-shirts you will need to process payment for those after clicking 'Proceed to Payment'.

When: 15-19 January 2027
Where: Rathane Youthworks Campsite, Port Hacking

PARENT’S / CAREGIVER’S DETAILS

EMERGENCY CONTACT DETAILS

CHILD 1

CHILD 2

CHILD 3

CHILD 4

PERMISSIONS FOR SUMMERCAMP27

Office hours

Monday – Friday
9am – 3pm

Contact

(02) 8908 4800
reception@st-thomas.org.au

Address

Corner of Church St & McLaren St North Sydney NSW 2060

Membership portal

Peter Procopio

Ben Radloff

SUMMERCAMP 2027

When: 15-19 January 2027Where: Rathane Youthworks Campsite, Port Hacking

PARENT’S / CAREGIVER’S DETAILS

EMERGENCY CONTACT DETAILS

CHILD 1

CHILD 2

CHILD 3

CHILD 4

PERMISSIONS FOR SUMMERCAMP27

Peter Procopio

Ben Radloff

When: 15-19 January 2027
Where: Rathane Youthworks Campsite, Port Hacking