Please enable JavaScript in your browser to complete this form. - Step 1 of 6 Thank you for applying as a Camp Champ with Young Life! As well as providing these details, you will be required to have a working with children check as per your State/Territory requirements; and to complete Young Life's online volunteer training. Please make sure you have to hand the following: - Emergency Contact Details - Medical Details - Medicare Numbers & Family GP Details - Allergy & Medication Details NextType of registrationType of registrationCabin Leader RegistrationWork Crew Registration (Over 18yrs)Summer Staff (Program, Tech, Activities)Choose your campCampSummer CampStudy CampYour Contact DetailsVolunteer Name *FirstLastEmail *Phone *Young Life Area *ArmidaleBarossa ValleyBathurstCanberraCaseyDubboGuyraHobartIpswichMonashParramattaPort AdelaideRedlandsRydeUrallaWarrenDon't KnowPlease choose your Young Life area or select 'Don't Know'.Would you like to register up to 3 accompanying family members? Family members who are volunteering should fill in a separate application) *YesNoTotal number of people I am registering1234Preferred Payment MethodPlease chooseI will pay the camp fee/deposit onlineI will pay my local Young Life leaderYou will be redirected to a secure payment page at the end of the registration process.NextVolunteer DetailsDate of Birth *DD12345678910111213141516171819202122232425262728293031/MM123456789101112/YYYY20232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Gender *Please chooseMaleFemaleAre you a returning volunteer?Please chooseYesNoWhat role is your first choice (depending on availability)Program teamTech team (video, sound, photography)Offsite activities (water, abseiling, hiking, lifesaving duties)Onsite activities (e.g. cafe, band, prayer)Medical team (nurses, doctors, first aid)Swimming ability *Can'tWeakFairStrongBronze CertificateSpecial Dietary Requirements *NoneVegetarianVeganOther (please specify below)Specific Dietary RequestFood Allergy Information *NonePeanutsEggsCoeliac/Gluten FreeLactose IntolerantOther (please specify below)Specific food allergiesMedical InformationVolunteer's Medicare no: *Medicare position no: *The individual reference no. to the left of your name on your medicare card.Expiry Date: *Please check the box where appropriate or leave box blankI object to transfusionsI wear glasses/contact lensesParacetamol may be givenIbuprofen may be givenAntihistamines may be givenDo you have an allergy? *YesNoPlease provide detail regarding your allergy *Other conditions or further information we should know about:MedicationPlease list Medication, Dosage and Self Administer Y/NMedia Consent: Young Life may take photos &/or video footage at Young Life activities to commemorate camp and use for promotional purposes. Tick the box below if you agree to appear in photos or footage. *AgreeDisagreeGuest1 Name *FirstLastDate of Birth *DD12345678910111213141516171819202122232425262728293031/MM123456789101112/YYYY20232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Gender *Please chooseMaleFemaleSwimming abilityCan'tWeakFairStrongSpecial Dietary Requirements *NoneVegetarianVeganOther (please specify below)Specific Dietary RequestFood Allergy Information *NonePeanutsEggsCoeliac/Gluten FreeLactose IntolerantOther (please specify below)Specific food allergiesMedical InformationMedicare no: *Medicare position no: *The individual reference no. to the left of your family member's name on the medicare card.Expiry Date: *Please check the box where appropriate or leave box blankI object to transfusionsCamper wears glasses/contact lensesParacetamol may be givenIbuprofen may be givenAntihistamines may be givenDoes your family member have an allergy? *YesNoPlease provide detail regarding your family member's allergy *Please provide detailOther conditions or further information we should know aboutMedicationPlease list Medication, Dosage and Self Administer Y/NMedia Consent: Young Life may take photos &/or video footage at Young Life activities to commemorate camp and use for promotional purposes. Tick the box below if you agree to photos or footage of your family member/child/guardian being used. *AgreeDisagreeGuest2 Name *FirstLastDate of BirthDD12345678910111213141516171819202122232425262728293031/MM123456789101112/YYYY20232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Gender *Please chooseMaleFemaleSwimming abilityCan'tWeakFairStrongSpecial Dietary Requirements *NoneVegetarianVeganOther (please specify below)Specific Dietary RequestFood Allergy Information *NonePeanutsEggsCoeliac/Gluten FreeLactose IntolerantOther (please specify below)Other dietary requirements including specific food allergiesMedical InformationMedicare no: *Medicare position no: *The individual reference no. to the left of your family member's name on the medicare card.Expiry Date: *Please check the box where appropriate or leave box blankI object to transfusionsCamper wears glasses/contact lensesParacetamol may be givenIbuprofen may be givenAntihistamines may be givenDoes your family member have an allergy? *YesNoPlease provide details regarding your family member's allergy *Please provide detailOther conditions or further information we should know about:MedicationPlease list Medication, Dosage and Self Administer Y/NMedia Consent: Young Life may take photos &/or video footage at Young Life activities to commemorate camp and use for promotional purposes. Tick the box below if you agree to photos or footage of your family member/child/guardian being used. *AgreeDisagreeGuest3 Name *FirstLastDate of BirthDD12345678910111213141516171819202122232425262728293031/MM123456789101112/YYYY20232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Gender *Please chooseMaleFemaleSwimming abilityCan'tWeakFairStrongSpecial Dietary Requirements *NoneVegetarianVeganOther (please specify below)Specific Dietary Request (copy)Food Allergy Information *NonePeanutsEggsCoeliac/Gluten FreeLactose IntolerantOther (please specify below)Other dietary requirements including specific food allergyMedical & Allergy DetailsMedicare no: *Medicare position no: *The individual reference no. to the left of your family member's name on the medicare card.Expiry Date: *Please check the box where appropriate or leave box blankI object to transfusionsCamper wears glasses/contact lensesParacetamol may be givenIbuprofen may be givenAntihistamines may be givenDoes your family member have an allergy? *YesNoPlease provide detail regarding your family member's allergy *Please provide detailOther conditions or further information we should know aboutMedicationPlease list Medication, Dosage and Self Administer Y/NMedia Consent: Young Life may take photos &/or video footage at Young Life activities to commemorate camp and use for promotional purposes. Tick the box below if you agree to photos or footage of your family member/child/guardian being used. *AgreeDisagreePreviousNextEmergency Contact DetailsFull Name of your Primary Emergency Contact *Primary Phone *Residential Address *Address Line 1CityState / Province / RegionPostal CodeAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBolivia (Plurinational State of)Bonaire, Saint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCongo (Democratic Republic of the)Cook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Kingdom of)EthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIran (Islamic Republic of)IraqIreland (Republic of)Isle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea (Democratic People's Republic of)Korea (Republic of)KosovoKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesia (Federated States of)Moldova (Republic of)MonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth Macedonia (Republic of)Northern Mariana IslandsNorwayOmanPakistanPalauPalestine (State of)PanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint Maarten (Dutch part)SlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyrian Arab RepublicTaiwan, Republic of ChinaTajikistanTanzania (United Republic of)ThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUgandaUkraineUnited Arab EmiratesUnited Kingdom of Great Britain and Northern IrelandUnited States Minor Outlying IslandsUnited States of AmericaUruguayUzbekistanVanuatuVatican City StateVenezuela (Bolivarian Republic of)VietnamVirgin Islands (British)Virgin Islands (U.S.)Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland IslandsCountryFull Name of Secondary Emergency Contact *Secondary Phone *Address *Address Line 1CityState / Province / RegionPostal CodeAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBolivia (Plurinational State of)Bonaire, Saint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCongo (Democratic Republic of the)Cook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Kingdom of)EthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIran (Islamic Republic of)IraqIreland (Republic of)Isle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea (Democratic People's Republic of)Korea (Republic of)KosovoKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesia (Federated States of)Moldova (Republic of)MonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth Macedonia (Republic of)Northern Mariana IslandsNorwayOmanPakistanPalauPalestine (State of)PanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint Maarten (Dutch part)SlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyrian Arab RepublicTaiwan, Republic of ChinaTajikistanTanzania (United Republic of)ThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUgandaUkraineUnited Arab EmiratesUnited Kingdom of Great Britain and Northern IrelandUnited States Minor Outlying IslandsUnited States of AmericaUruguayUzbekistanVanuatuVatican City StateVenezuela (Bolivarian Republic of)VietnamVirgin Islands (British)Virgin Islands (U.S.)Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland IslandsCountryPrivate Health Insurance fund & no:Name & Phone Number of Family GPPreviousNextIndemnity and ConsentPlease read carefully and provide your consent.Sun Protection: It is expected that you/your child/children come to camp with a hat, t-shirt (that covers shoulders) & sunscreen. I acknowledge that I will ensure I/my child/children attends camp with these items. Should my child attend camp without a hat, t-shirt & sunscreen, Young Life Australia in the first instance will call me and request I provide Young Life with the finances for them to purchase the items for my child and in the second instance will request my child remain in shaded areas, therefore excluding them from some activities. *AgreeConsent to medical attention: I, the undersigned confirm my consent to the activities I/my child/children will engage in while on a Young Life activity or camp. I acknowledge the staff and volunteer agents of Young Life will take all possible care but cannot be held responsible for unforeseen accident or illness arising. I hereby consent to medical, hospital, rescue procedures being employed in the best interests of myself/my child/children and that I shall be notified as soon as possible should the continuance of such procedures be necessary. *AgreeDisclaimer: In the unforeseen event of personal injury or illness sustained while on a Young Life activity or camp, or the loss of personal property except where such property was held in the custody of Young Life staff or volunteer agents when lost while on a Young Life activity or camp, I hereby release, and exempt, and indemnify the organisers, sponsors, and all other persons involved in the organisation of the Young Life camp, trip, excursion, from all action, proceedings, demands, costs, expense, and claims whatsoever made or taken by any person arising out of my/my child/children’s participation in such camp, trip, or excursion. *AgreeDiscipline: If in the event my or my family member's behaviour is deemed by the organisers to be inappropriate or compromises the safety and/or health of other Attendees on the camp, trip or excursion, then Young Life reserves the right to suspend my role and arrange travel home, at my expense, at the earliest possible time, by the most effective mode of transport, in conjunction with my co-operation. *AgreePreviousNextYour Registration is almost complete! Your privacy: The personal contact/address details you supply on this form will be entered into our database. We may use it to send you further information about Young Life Australia. Young Life Australia adheres to the Privacy Act and will not disclose this information to third parties. If you would like to know what information Young Life holds about you please call 1300 557 647.I consent to receiving information from Young Life AustraliaTerms and Conditions *I have read and accept the Terms and ConditionsNameSubmit