Somers Camp 2019 Slushie Application Form
Thank you for applying to attend Somers Camp 2019 as a slushie!
Slushie year is one of the greatest Somers experiences - we're so excited for this years slushie team!
This form should be completed by a parent or guardian.
The application will take around 10 minutes to complete - unfortunately there's no save feature so you'll need to complete the form in one sitting.
There are a few things you should gather before you begin to fill out this form;
Please have with you (if applicable):
- a list of any medications you/your child are taking
- Medicare card
- Medical/hospital fund information
- Ambulance member number
Should you have any questions about the camp or about this form please email our Core team at Core@somerscamp.com.au and one of our friendly team will be in touch in you shortly
Your application will not be completed until our terms and conditions agreement is signed and returned. If you don't have a copy you can download one at
, or simply email the above address and we'll send you a copy.
You can attach it to this form or post it to us at the address included at the top of the indemnity form.
Want some more info on what a slushie is? Visit the videos page of our website and watch the slushie video.
Please note: any field with a red star is a required field.
IMPORTANT DATES TO PUT IN YOUR DIARIES
2019 before Somers team meeting – Sunday 23rd June (afternoon Meeting followed by dinner)
Somers Camp Set-up – Sunday 30th July (at Lord Somers Camp)
Somers Camp 2019 – Monday 1st July – Friday 5th July
Somers celebration dinner – Saturday 6th July
After Somers Meeting – Sunday 11th August - afternoon meeting followed by campers afterparty
Preferred Name - for badges and T-shirts
Date of Birth
if different to residential address
This is the primary email address where all camp details will be sent
Confirm email address
Which school do you attend?
Church congregation (if applicable)
Please note: at least one contact number must be provided.
Please enter phone numbers with spaces, eg:
03 5974 ####
0418 586 ###
Home telephone number
Emergency Contact (other than parent/guardian)
I wish to apply for
Slushie - $210
I wish to pay by
Payment details will be sent to you with the camper acceptance letter.
electronic transfer (preferred)
cash at camper registration (1st day of camp)
if you would like to make a donation to Somers Camp please specify an amount here. Donations go towards helping children attend camp who would otherwise be unable to afford the fees.
To show our appreciation every slushie gets a free T-shirt!
XS - 41cm wide, 51cm long
S - 43cm wide, 56cm long
M - 46cm wide, 60cm long
L - 48cm wide, 64cm long
XL - 51cm wide, 67cm long
Why would you like to be a slushie?
Please explain in a paragraph what motivated you to apply to be slushie? You may wish to reflect on skills you have, and previous experiences at Somers Camp.
This section of the form should be completed by a Parent / Guardian
Please specify if your child suffers the following
Asthma, Blackouts, Heart Condition, Migraines, Diabetes, Sleepwalking, Bedwetting, or Other
To help the leaders ensure that your child enjoys all camp activities to the full, it would be useful if you could let us know of any learning, communication, social or behavioural difficulties they may have:
Is your child currently taking medication?
If yes please specify (name, dosage etc)
Should your child become unwell or suffer an injury do you agree to camp nurse or camp mum giving your child paracetamol?
Yes - 1 tablet only (or 5ml liquid)
Yes - 2 tablets (or 10ml liquid)
Please specify any drugs your child is allergic to
Does your child have other allergies?
Has your child had a meningicoccal immunisation?
Last tetanus immunisation:
Position on card:
Ambulance Member No:
Please list any foods your child is allergic to
I confirm that the information provided is correct
Somers Camp is run by a dedicated team of volunteers.
To save time, money, and paper we try to send all our communications via email and SMS.
This includes acceptance letters, important camp updates, and information on our Post Somers Worship event.
Would you like to help our admin team out by receiving all communication electriconically?
Yes, please send all correspondence via the email address I provided at the begining of the form.
No, please send all correspondence via the postal address I provided at the begining of the form.
Please note: If posting is required an additional $2 will be added to the total cost of the camp
How did you hear about Somers Camp?
Notes and feedback:
We're always trying to make the Somers journey easier and stress free,
If there's any way you think we could improve this form please let us know :)
Terms and conditions
Please note: To complete your application you will need to sign our terms and conditions. You can download them at our website (
Please attach a signed copy to this form. Alternatively you can email it to email@example.com or post it to the address at the top of the terms and conditions document
Send me a copy of my responses
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