Somers Camp 2019 Camper Registration Form
Congratulations on your decision to register for Somers Camp 2019!
We're all so excited for camp this year and can't wait to share the experience with you.
The registration will take around 10 minutes to complete - unfortunately, there's no save feature so you'll need to complete the registration in one sitting.
This form needs to be filled out by a parent, or legal guardian, of the camper.
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 your child is taking(including dosages)
- Medicare card
- Medical/hospital fund information
- Ambulance member number
Should you have any questions about the camp or this registration form, please email us at email@example.com and one of our team will be in touch with you shortly.
Please note: To complete your registration you will need to sign and return our terms and conditions agreement. If you don't have a copy, you can download one at
, or 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 terms and conditions document.
**any field with a red star is a required field.
IMPORTANT DATES TO KEEP IN YOUR DIARY
SOMERS CAMP 2019 - Monday 1st July until Friday 5th July
SOMERS CAMP AFTERPARTY – Sunday 11th August (afternoon)
Campers First Name
Preferred Name (for badges)
School year level
Date of Birth
(if different to residential address)
Note: This should be the contact email address of the parent or guardian (not the camper)
Please confirm your email address
please take a moment to confirm your email address
Siblings on camp
Will you be sending other Siblings on camp this year? If so please list their first and last names here.
Church congregation (if applicable)
School your child attends
please note: at least one contact number must be provided.
Please enter phone numbers with spaces, eg:
03 5974 ####
0418 586 ###
0418 586 ###
Home telephone number
Work telephone number
Emergency Contact (other than parent/guardian)
I wish to apply for
Each year our volunteer leaders work tirelessly to raise funds and gather donations to help keep the cost of Somers Camp to a minimum.
We're so excited to announce that over the past 12 months our team have done such a great job fund raising that we have been able to reduce the cost of camp by almost 10%.
If you are interested in making a small donation there is an option below to specify an amount. Every dollar counts so we appreciate anything you may be able to contribute.
Primary Camper - $250
Secondary Camper - $250
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.
I wish to pay by
If you select electronic transfer you will receive an email with the relevant details
electronic transfer (preferred)
cash at camper registration (1st day of camp)
I would like to order a T-shirt
If you are ordering a T-shirt for your child please make you fill in the size and color options.
Please note: No T-shirt orders can be accepted after 30th May
yes - $35
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
Is this the first time your child has been away from home without the company of a parent / guardian?
Please specify if your child suffers the following
Asthma, Blackouts, Heart Condition, Migraines, Diabetes, Sleepwalking, Bedwetting, or Other
We want your child to enjoy camp so please share with us in confidence any information that will help the leaders. This information is seen by Camp Mum and Camp Nurse and is shared only with the relevant leaders.
eg. difficulties with learning, communication, social or behaviour?
recent family breakdown or bereavement? recent experience of bullying?
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 as well as resulting symptoms
Please specify any Foods your child is allergic to, detail any resulting symptoms
Does your child have other allergies?
Has your child had a meningicoccal immunisation?
Last tetanus immunisation:
Position on card:
Ambulance Member No:
I confirm that the information provided is correct
Somers Camp is run by a dedicated team of volunteers. This year we are trying to streamline our systems for communication. We have implemented a new project management software that automatically collates application forms and contact details. This saves hours of work for our volunteers and enables us to process information much faster. We would love if you could support us with this new system by allowing us send all future communication (like acceptance letters) via your email address rather than via post. This will save time, money, and paper.
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 registration fees
How did you hear about Somers Camp?
Notes and feedback:
Please attach your signed indemnity form. If you don't have access to a scanner you can post it to us at the address at the top of the indemnity form.
If you dont have an indemnity form you can download one at Somerscamp.com.au
Send me a copy of my responses
Your submission is being processed. Please do not close this browser window until complete.