Camp Participant

First Name

Last Name

Gender

Birthday

/ /

Mobile

Address

Is CityLife your home church?

Which site do you attend?

School Year level in 2027

Your Camp Site

Parent/Guardian Details

Parent's First Name

Parent's Last Name

Parent's Email Address

Parent's Mobile Number

Please provide the name and number of an individual we can contact in the unlikely event of an emergency.

Emergency Contact Name

Emergency Contact Number

Medical Conditions

Are you on any medication?

Do you suffer from any medical conditions?

Do you have any dietary requirements?

Are you anaphylactic to anything?

Do you have an Anaphylaxis Plan?

Please email your Anaphylaxis plan to youth@citylife.church.

Do you have asthma?

Do you have an Asthma plan?

Please email your Asthma plan to youth@citylife.church.

Is there anything else the Youth Team should know to help better support you over this Camp?

Do you suffer from any of the following:

Travel Sickness

Heart Problems

Diabetes

Epilepsy

Terms and Conditions

All information submitted in this form will be handled in accordance with the CityLife Church Privacy Policy. For more information see http://www.citylife.church/privacy/.  No GST has been charged for this event. Should you find yourself unable to attend after registering, please contact the youth staff on 9871 8300 or via youth@citylife.church to discuss a refund or transfer of registration.

By taking part in this event, you give CityLife Church permission to take and use images and/or footage of me/my child at this event and for EPIC Youth related events for promotional purposes.

By proceeding to the next page, you agree to the above Terms and Conditions.