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CAMPER + LEADER REGISTRATION

Disclaimer - All information provided in this form is private and confidential, and will only be used by the Dunedin Eastercamp Planning Team for camp purposes.

Personal Information

Gender
I am a...

What youth group are you coming to camp with?

Ask your Youth Group Leader to Register if not shown below

Dietary Requirements

Please select as many that apply to you. If none, check "N/A".

Medical Information

Make sure your key youth leader is aware of any medical needs for camp, as they are responsible for you during camp.

Do you have any pre-existing medical conditions/disabilities?
Do you take any medication regularly?

Emergency Contact

Contact Information for a parent/guardian in case of an emergency

Promotional Disclaimer

I give permission for any photo and/or video material taken of me at camp to be used in future promotional material.

Is there anything else you need to tell us?

Thanks for submitting!

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