2024 Pathfinder Camporee – Individual Applications

Attendee Details

First Name

Last Name

Email

Phone

Date of Birth

Age at Event Date

Gender

Attendee Type

Role in Club

Pathfinder Club

ADMIN FORM ENTRY

Yes

No

Club Details

Estimated Time of Arrival/Registration

Estimated Club Attendance

Estimated Number of Pathfinders

Estimated Number of Staff

Designated Cook/s

First Name

Last Name

Add a second cook

Yes

No

First Name

Last Name

Add a third cook

Yes

No

First Name

Last Name

Teen Force

Do you want to be a part of an exciting team that will deliver a fantastic Camporee for WA in 2024?

You must be:

Aged 16-18
A registered Pathfinder in a Pathfinder club
Keen to develop your servant leadership potential
Available each evening and for a morning OR afternoon roster
Willing to support your own club when not rostered on Teen Force activities.

Teen Force Volunteers will be involved in:

Creating memory theme events
Assisting Activity Leaders
Providing special dynamics at the evening program
Assisting in ‘Temple Worships’ and Sabbath services.

I would like to be a part of Teen Force

Yes

No

Why would you like to be a member of Teen Force?

Parent/Guardian Details

Parent/Guardian #1

First Name

Last Name

Email

Phone

Relationship to Attendee

Add another parent/guardian

Yes

No

Parent/Guardian #2

First Name

Last Name

Email

Phone

Relationship to Attendee

Emergency Contact

First Name

Last Name

Phone

Relationship to Attendee

Secondary Emergency Contact

First Name

Last Name

Phone

Relationship to Attendee

Health Record

Please complete your medical and emergency details below.

All information is stored securely and accessed only by authorised personnel (i.e. event leaders, first aiders).

For event safety, it is vital that the information is up to date when the event begins. If you have any questions or would like to update the medical information you provide, please do not hesitate to contact us at wayouth@adventist.org.au

General

Medicare Number

Position on Medicare Card

Do you have ambulance cover?

Ambulance Cover Provider

Do you have private health insurance?

Private Health Insurance Provider

Private Health Insurance Member Number

Do you object to transfusions?

Date of last tetanus vaccination

Any non-medical dietary requirements?

Please advise any other non-medical dietary requirements

Medical Conditions

Please list below any known medical conditions or care notes, including:
allergies (anaphylactic), allergies (non-anaphylactic), anorexia/ eating disorders, asthma, autism, bed-wetting, blackouts/ dizziness/ fainting, bleeding disorder, diabetes, disability, eczema/ skin condition, epilepsy/ seizures, hearing impairment, heart condition, joint/ muscle/ bone problems, migraines, operations, phobia, recent illness, sleep walking, sight impairment, travel sickness, mental health issue. heart problems, respiratory problems, travel sickness, any other medical issue or care note.
Please email all action plans (i.e. anaphylaxis, asthma, diabetes) to wayouth@adventist.org.au

Add medical condition/care note

Medical Condition/Care Note 1

Symptoms

Triggers

Medication

Care Instructions

Add another medical condition/care note

Medical Condition/Care Note 2

Symptoms

Triggers

Medication

Care Instructions

Add another medical condition/care note

Medical Condition/Care Note 3

Symptoms

Triggers

Medication

Care Instructions

Medical Contact (Optional)

Add doctor’s details

Doctor’s Name

Practice Name

Phone Number

Non-Prescription Medication

Should my child feel unwell, I give permission for the StormCo staff to provide:

Paracetamol

Yes

No

Ibuprofen

Yes

No

Anti-Histamine

Yes

No

Working With Children Check & Adsafe

Attendees aged 18 or above must:

– Have a valid Working With Children Check

– Have completed Adsafe Awareness Training within the past 3 years

– Have signed the Adsafe Code of Conduct

Working With Children Check – Website

Adsafe – Website

Working With Children’s Check Number

Working With Children Check Expiry Date

I have completed Adsafe Awareness Training within the past 3 years

I have signed the Adsafe Code of Conduct

Consent & Release Form

I declare that I have read the information regarding the Western Australian State Pathfinder Camporee to be held on September 20th – 23rd 2024.

I understand that there is an element of risk involved in activities. I agree to be responsible, to understand and follow the safety guidelines for each activity and to follow the instructions of the activity leaders. I acknowledge that I may refuse to participate in any part of the activities I feel apprehensive about (if this does not endanger myself or other participants and leaders).

I agree that if I suffer injury or illness, the organisers will make every effort to contact the parent/guardian/next of kin by way of the details provided should such a situation arise, and can arrange medical treatment and emergency evacuation services, as they deem necessary for my safety or wellbeing.

I am aware, in signing this document, of the risks and demanding nature of the Western Australian State Pathfinder Camporee and am willing to accept these risks and agree to release, to the full extent permitted by law, the SEVENTH-DAY ADVENTIST CHURCH (WA Conference) LIMITED and/or its employees and agents from responsibility for any injuries which I may suffer as a result of participation in this event.

I understand that video footage and/or photographs may be taken of attendees during the WA State Pathfinder Camporee. Photographs and video recordings may be used during the program, in Connect articles, reports, on social media and our webpages. I consent to be photographed and recorded for this purpose.

Payment & Form Submission

Fees

Early Bird – $135
(Closes 2 August)

Regular – $150
(Opens 3 August – Closes 6 September)

Late – $170
(Open 7 September – Closes 13 September)

Discounts

Pilbara Region
Attendees from the Pilbara region will receive a discount of $45.

Cooks/Caterers
Club cooks/caterers will receive a discounted fee of $80. Clubs may nominate up to three cooks/caterers.

Do you qualify for the Pilbara region discount?

Yes

No

Late Fee with Discount Applied

Price: $125

Late Fee

Price: $170

Cook/Caterer Fee

Price: $80

Cook/Caterer Fee with Discount Applied

Price: $35

ADMIN FORM

Price: $0

No payment items has been selected yet

Pay with Card (Stripe)

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2024 WA State Camporee

September 20 – 23
Mornington Adventure Camp

Attendee Details

Club Details

Estimated Time of Arrival/Registration

Estimated Club Attendance

Designated Cook/s

Teen Force

Parent/Guardian Details

Parent/Guardian #1

Parent/Guardian #2

Emergency Contact

Secondary Emergency Contact

Health Record

General

Medical Conditions

Medical Contact (Optional)

Non-Prescription Medication

Working With Children Check & Adsafe

Consent & Release Form

Payment & Form Submission

2024 WA State Camporee

September 20 – 23Mornington Adventure Camp

Attendee Details

Club Details

Estimated Time of Arrival/Registration

Estimated Club Attendance

Designated Cook/s

Teen Force

Parent/Guardian Details

Parent/Guardian #1

Parent/Guardian #2

Emergency Contact

Secondary Emergency Contact

Health Record

General

Medical Conditions

Medical Contact (Optional)

Non-Prescription Medication

Working With Children Check & Adsafe

Consent & Release Form

Payment & Form Submission

September 20 – 23
Mornington Adventure Camp