Youth Development Camp

Emergency contacts when you are at camp

To attend the Outdoor camp, you must be able to say YES to each highlighted question

I am or my family is a member of the NZDSA

I will be 18 or older by the date of the camp

I will complete all tasks before, during and after the camp

I will share the information and experience with others

I am willing to follow instructions so we all have a positive time and minimise risks

I have experience with air travel and overnight stays at a hotel/camp

I am vaccinated and my COVID-19 vaccinations are current

I am fit and will participate in walking and adventure activities

I am willing to fully participate in the training

I am independent and can take care of my personal needs/cares

I regularly participate in a social/recreation/leadership group (if there is one in your area)

I have a support person who can assist me with post-course work.

To attend the Outdoor camp, you must be able to say YES to each highlighted question

I have read and understood the attached Traffic Light Behaviour - Code of Expected Behaviour - and I know what behaviour is expected of me

I know that I will need to follow the health and safety guidelines provided so that I can keep safe and to help others to be safe

I give permission for my e-mail address to be circulated to the other participants who attend the camp

I give permission for my home number to be circulated to the other participants who attend the camp

I give permission for my mobile number to be circulated to the other participants who attend the camp

Physical description, please include the following:

Special Dietary Requirements: Please note all in this section

Do you have any allergies, e.g. bee stings, penicillin

Do you have any medical conditions?

Please read the following and then sign

• In the event of an accident or illness, I authorise the obtaining of any medical assistance on my behalf as may be deemed necessary by the staff of NZDSA.
• I understand and agree that I need to follow the Health and Safety Guidelines provided and that everyone attending is responsible for taking the necessary measures to ensure their own and others’ safety.
• I accept that whilst the New Zealand Down Syndrome Association Incorporated (NZDSA) staff, volunteer support workers and other organisations will exercise due care and employ health and safety risk management techniques in both support and activities, it will not be liable for injury, damage or loss which a delegate may sustain to themselves or their property whilst attending the NZDSA Youth Development Camp.
• I accept responsibility for my own actions and safety.
• I understand that the NZDSA will not accept responsibility for loss or damage of personal property.
• I have completed these forms to the best of my knowledge. I have read and understood the statement with regard to risk management and the privacy portion of this form. I have completed the criteria for attendance list. I agree to participate in the assigned tasks.

Privacy

The information provided will only be used for risk management purposes and for our records. Your information will not be given to any other agency or person without your permission.