Camp 180 Information request Camper Name* First Last Birthday DD slash MM slash YYYY Gender*MaleFemaleSchool Year*789101112Medical ConditionsDietary RequirementsParent/Guardian Names*Your Email* Emergency Phone* I hereby consent and agree for North Coast Youth to take photographs and video footage of my child/children and to use these in future Camp 180 promotion material and North Coast Youth social media.YesNoI consent to the provision of first aid and the provision of analgesics in the case of my child/children requiring medical treatment or the in case of a medical emergency. I authorise North Coast Youth, where it is impracticable to communicate with me, to arrange for my child/children to receive such medical or surgical treatment or ambulance transport as may be deemed necessary. I undertake to pay any costs that may be incurred for the medical treatment, ambulance transportation and medications.YesNoNameThis field is for validation purposes and should be left unchanged.
