Mid Year Camp Form 09

University of WA Catholic Society Bringing Peace Wherever We Go

Mid Year Camp 2009 Enrolment Form This form is due by Monday June 16, 2009. Personal Details: Name: _________________________________________________________________________________ Address: ________________________________________________________________________________________ ________________________________________________________________________________________ Mobile Number: __________________________ Home Number: ________________________________ Email: __________________________________________________________________________________ Student Number: ______________________ Year: ____________________________________________ Date of Birth: ___________________________. Course: ________________________________________________________________________________ Are you a UCS Member? _________________________________________________________________ To facilitate friendship, a list of names and contact details of the camp participants is given to those attending the camp. I am happy that my contact details be included (Y or N): ___________________

Do you have a medical condition that we should know about? (I.e. allergies, diabetes, asthma etc.) _______________________________________________________________________________________ Do you have any dietary requirements? (I.e. vegetarian)_____________________________________ Do you need transport to and from the camp? (Y or N) ______________________________________ Are you able to offer transport to anybody else? If so, how many people? ______________________ (You will be contacted if you require transport or if you can offer transport). Please arrive after 2pm at the campsite on Sunday, June 29.

Cost:

$100

University of WA Catholic Society Bringing Peace Wherever We Go The total cost of all three nights is $100 for members and $110 for non-members. All food, accommodation and activities are included in the price. There will be separate male and female dorms, this is not a drinking society camp. Just bring warm clothing, linen or sleeping bags, towel and toiletries. We understand you may not be able to attend for the whole duration of the camp. If you cannot attend for the whole duration of the camp please email Geetu Arora, the UCS President, at [email protected] to make other financial arrangements. Payment is made by: □

a cheque payable to the ‘University Catholic Society’; or

□

cash.

Please email this form to [email protected] or return the form in an envelope to Father Armando’s office (Rm 1.12 on 1st Floor, South Wing of Student Services, Guild Village), with the payment for the camp. Alternatively you may leave it in his mailbox on the second floor of student services. If you return your form by email please bring payment for camp to the camp itself. You are welcome to bring payment to the camp itself, but please send this form in by the due date. Emergency contact: Emergency contact: _______________________________________________________________ Phone number(s):_________________________________________________________________ Your relationship to the person: ____________________________________________________

Disclaimer: UCS will take all care to ensure the safety of participants whilst on the camp. However all attendees of the camp are responsible, as far as is reasonable, for their own conduct and UCS will not be responsible for anything occurs outside its duty of care. In signing hereby you acknowledge this. ________________________________________________________________________________________