Event Registration - Latimer Church

Event*

I am registering for:*

A whole team (6 people)
A partial team - please join us with others
As an individual - please add me to a team

Team Name (if you have one)

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Date*

Name*

First Last

Names of others in your group (that you are also registering for)

Name of Youth*

First Last

Other Team Members (if registering as a team)

Adult 1*

First Last

Adult 2

First Last

Gender*

Male
Female

Age*

Date of birth

School currently attending*

School Year*

Day's attending*

Tuesday
Wednesday
Thursday
Friday

Is there someone you’d like to be in the same group as?

Address*

Street Address Address Line 2 City ZIP / Postal Code

Youth Phone

Parent/Caregiver's Name*

First Last

Phone*

Emergency contact phone*

Email*

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Children

Please include the name and age of all childrenattending camp with you.

Child's name	Age

I am coming:

For the whole weekend ($120)
For the day on Saturday ($50)

Name of second emergency contact if primary caregiver can't be reached*

First Last

Phone number for emergency contact*

Suburb / Area

Can you provide a tent?

Yes
No

If yes, how many can people can your tent sleep?

Payment - whole weekend

I can pay the whole amount.
I would love to come but can't pay the full amount. I could pay $__ (enter amount below).
I can pay the whole weekend and would love to donate $__ (enter amount below) to help someone else get to the weekend as well.

Amount

Do you have any particular house requests?

People in a house with, need own room etc.

Dietary Requirements / Allergies etc

Special needs or things we need to know about

Preferred Time of Group:*

Tuesday evening
Wednesday evening
Thursday evening
Other (please comment below)

Mobile

Camp package*

Family - Accommodation ($300)
Individual adult - Accommodation ($100)
Child aged 2-17 - Accommodation ($50)
Day only - Saturday ($25 adult / $15 child)
Days only - all weekend ($35 adult / $20 child)

Number of guests

Comments/Other information: