Somers Camp 2018 Leaders Application Form

Thanks for applying to a part of the 2018 Somers Leadership team

Serious wordy bit:
This application is to be completed by any person wishing to apply to be a leader on the 2018 Port Phillip East Presbytery Children’s Camp (Somers Camp). In selecting a team of leaders for Somers Camp, it is important to ensure there is a balance of skills, experience and enthusiasm. Completing this form will enable the Somers Core team and the Port Phillip East Presbytery to ensure that an appropriate and complementary team is selected.

Leadership positions involve interaction and supervision of minors. Somers Camp is a child and youth safe organisation committed to the protection of children and young people. All successful applicants will be carefully screened.

Please understand that completing this form does not guarantee you a position on the leadership team. Places are limited due to the size of the campsite (accommodation and catering restrictions).




Please save these dates in your diaries:

> **LEADERSHIP CONFERENCE** - Friday 20th April late afternoon - Sunday 22nd April late afternoon
> Before Somers leaders meeting – Sunday 24th June (Afternoon Meeting followed by dinner)
> Somers Camp Set up – Sunday 1st July
> Somers Camp 2017 – Monday 2nd July - Friday 6th July
> Somers celebration dinner – Saturday 7th July
> After Somers Meeting – Sunday 12th August

Camp costs for leaders - $190. This includes food and accommodation at the Somers Leadership Conference, Somers Camp and a Somers 2017 theme T-shirt



Thankyou for taking the time to fill out our online application form. Unfortunately there is no “save” feature on this form so you will have to complete it in one sitting. This can take anywhere from 15 minutes to 30minutes.

To make it easier and to save time please make sure you have the following information ready before you start:

If you are over 18 you will need a ‘Working with Children’s Check’(WWCC). Please note that this is not a ‘required field’ in the application form however a WWCC must be provided Before the leaders training weekend.
2 referees with contact phone numbers. One of these referees can be a somers leader over 21 years of age. Please be sure to ask the referee permission before you supply their contact details.
If you are under 18 you will need a parent or guardian to fill out the indemnity section of the form.
Medicare number and position on card.
Medical / hospital fund (and contribution number)
Ambulance member number
Name and address of family doctor













Please note at least one contact number needs to be provided










Any leader aged 18 or older MUST provide evidence of a working with children check (WWCC). Application forms can be collected at your local post office. Any leader over 18 that fails to provide a WWCC number before the leaders training weekend will be unable to attend Somers Camp.




If this will be your first year leading at Somers Camp, please put '0'










Every leader on camp receives a themed Somers T-shirt. Please give us an indication of the size you would prefer.
If you're not 100% certain on your size we recommend ordering a size larger and being gangsta for a week



Hoodies cost $50




Hoodies are available in Dark Grey, Navy Blue, Baby Blue, Sand - if you dont like the sound of these put in a request and we'll see what we can do :)


You may find some of the questions below present issues that you haven't thought a great deal about. That's OK. You are encouraged to complete the form openly and honestly, with as much detail as you are able.


What motivated you to apply for a leadership role at Somers Camp?


As a leader what can you offer Somers Camp? you may like to reflect on your skills and passions.


Please give us some examples of when you have worked in a team situation.


Which aspects of leadership are you most passionate about?


Please tell us about your spiritual life and faith journey - there are no right and wrong answers here, we just appreciate your honesty


Are there any aspects of leadership that you are nervous about or you feel you would benefit in some training on?


FOR TRAINEE LEADERS (1st and 2nd year leading at Somers)

Trainee leaders are assigned mentors. Is there someone you would like to be considered for this role?
Please tell us why you are requesting this person.



FOR LEADERS (3 years+)


Please use this space to provide any additional information you feel will help us. Or to list any questions you have.


Please list 2 adults, who will be contacted by the Somers Core to act as referees for you. Particularly in relation to your work with 8 to 15 year olds and your demonstrated skills and experience. These people cannot be related to you. You may use one Somers leader of the age of 21.






Please note at least one contact number needs to be provided








Please note at least one contact number needs to be provided






The remainder of this form is to be completed by the leader if aged 18 or older, or by the parent / guardian if the leader is under 18 years of age.




or other emergency contact if you are over 18


please note at least one contact number must be listed






"I, the parent / guardian (or yourself if you are over 18), am willing that I/my child should participate in the Port Phillip East Presbytery Children's Camp ("Somers Camp") to be held from 2nd July 2018 until 6th July 2018. I understand the nature of the activities at the camp will include, but may not be limited to beach hiking, ropes course, games, dormitory accommodation, communal eating, dancing and that risks may arise during these activities. I understand that every effort will be made to contact me or my nominated connection, in the event of any illness or accident. I HEREBY AUTHORISE an appropriate leader of the particular activity in which I/my child is involved to consent, where it is impracticable to communicate with me, to my child/myself receiving such medical or surgical treatment as deemed necessary at any time during the camp. I further authorise the use of Ambulance if thought necessary. I accept responsibility for payment of all expenses associated with such treatment.


the information below is requested to assist in case of any illness or accident. This information will be held in confidence and this form will be destroyed after the camp.


Do you / your child suffer from any of the following: Heart condition.... Blackouts.... asthma.... sleep walking.... migraines.... other (please specify)


are you / your child currently taking medication? If yes please state the name of the medication and the dosage and frequency required.


are you / your child allergic to penicillin or any other drugs? (Please specify)


Do you / your child have any other allergies? i.e. insects, pollens, etc (please specify)


Do you / your child have any food allergies or dietary requirements? (please specify)


Have you / your child had a meningococcal vaccination?
















Thank you for taking the time to apply to be a Leader on Somers Camp 2018. You will receive an email shortly including a copy of the leader Expectations and Declaration. PLEASE NOTE your application is not complete until this form is filled in, signed, and either emailed or posted to us.




If you already have a WWCC please attached a coloured scan of your card. Front and Back






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