NOTE: This form autosaves the form data that you enter as you progress to ensure you don't accidentally lose your data if the page reloads accidentally etc. IF YOU ARE ON A PUBLIC DEVICE and there is potential that you may not complete the form, you can click the button below and we will not autosave your form data. All form data is cleared after the form is submitted successfully.

2020 Easter Family Camp Registration

Submission Successful

Thanks for registering for Easter Family Camp! We have sent you an email confirmation of your submission details. Please contact us if you do not receive this email.

Submission Details



Submission Date:

If you entered an email address, your submission details have been sent to you in an email.


Easter Family Camp


Great to hear you are thinking of joining us for Easter Family Camp in 2020!

Camp Dates: Sat 4th - Wed 8th Jan 2020

Protecting Your Privacy

Protecting your privacy and the confidentiality of your personal information is important to us as it is fundamental to the way we conduct Scripture Union Victoria. A copy of the Scripture Union Victoria Privacy Statement or detailed policy can be obtained from our website or office. From time to time, photos taken of Scripture Union Victoria activities may be used for promoting the many benefits to participants.

Information and photos from various activities may appear on the Scripture Union Victoria website or publications. Under no circumstances will the subjects in the photographs be personally identified without prior consent.

The information in this sheet will help us plan with care and safety. It in no way prejudices your application, but must be completed and returned before we can assume care.

Camper 1

Personal Details

Nickname, etc.


(if applicable)

(All address fields are required except Building Name)


I am happy for photographs to be taken of myself during my participation in this Scripture Union Victoria camp and I am willing for Scripture Union Victoria to use these photographs.

I understand that photos taken may be shared by the team with the campers and be used by Scripture Union Victoria in promotional material, publications and included on material used by Scripture Union Victoria for fundraising.

Swimming Ability

Dietary Information


We will endeavour to meet these requirements, and will contact you if there are any problems.

Medical Information

Please indicate in the relevant columns if you have had any of the following. Provide additional details in the box below if necessary.

Please provide additional information about the Specific Medical Conditions indicated above, including if there is a management plan in place.

If you have asthma, an allergy or anaphylaxis, you must include a management plan as part of your registration.

If you have asthma, an allergy, anaphylaxis, or other medical management plans, you must upload it here as part of your registration.




Please list below, including if there is a management plan in place. If you have a management plan, please email it to as part of your registration.

If you have a behavioural management plan, please upload it here as part of your registration.

Add Another Camper  
Remove This Camper

If you are finished adding Camper(s), click the 'next' button below OR use the navigation below to go to the next page in the form.

  Prev Next  

In the event of an emergency, please list phone numbers where a relative or friend may be contacted during the course of the program (other than those listed in your application).


Contact 1
Add Another Contact  

  Prev Next  

Insurance Information

Please give details of your medical insurances if applicable.



  Prev Next  

Your Agreement with Scripture Union Victoria

I acknowledge that some activities undertaken during camp can be hazardous. Furthermore, I understand that certain inherent risks and dangers may exist in the activities in which my family will be participating. I acknowledge that while Scripture Union Victoria and its leaders will take reasonable steps to provide a safe environment and to ensure all activities and equipment supplied by them for such activities is of a reasonable standard, Scripture Union Victoria will not be liable for any injury that may be suffered by my family, which arises either directly or indirectly from, or in connection with, the activity described.

I hereby agree to indemnify Scripture Union Victoria against any and all claims arising from, or in connection with, any injury that may be suffered by my family, or any injury my family may cause to another person, as well as any loss or damage to property, equipment or belonging to my family, or any other person, arising either directly or indirectly out of or in connection with the activity described.

I agree that, in my absence or when I am unable to, Scripture Union Victoria may authorize on my family's behalf whatever medical treatment my family may require. This includes, but is not limited to, ambulance attendance and hospital treatment. I agree to pay all medical expenses incurred.

I accept that Scripture Union Victoria staff and volunteers will transport my family where required.

I acknowledge that as a parent/guardian of my children, I will also, working collaboratively with Scripture Union Victoria and Camp Coolamatong staff and volunteers, seek to ensure the safety of my children for the duration of the camp.

I confirm that the information contained in this application is true and correct.

I agree to inform Scripture Union Victoria of any change to these details.

Your Details

This will be the email address that your registration confirmation will be sent to.


How did you hear about us?


Price list

Adult: $220
Secondary student: $175
Primary student: $160
Pre-school student: $115
Under 3: Free


Would you like to make a donation to the Camper Assistance Fund? This fund assists campers who are not in the financial position to attend camp, allowing them to also have a life-changing experience through camp.

(Enter amount in decimals e.g. 20.00 = $20)
  Prev Next  


Payment Method

Payment by Credit Card is MasterCard or VISA only. All major bank debit cards are also accepted. Please contact us if you have any issues.
You will receive an email with the details of how to finalise your direct deposit payment.

Payment Summary


Credit / Debit Card Details

Please click the submit button below and wait for your payment to process. Do NOT click the button more than once in quick succession or your credit / debit card may be charged multiple times.
Our website and payments are protected by the highest level encryption with SSL/HTTPS. Your data is securely and safely encrypted. Click the lock in the URL bar at the top for more information.

AUD $  
Save Form Progress