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Welcome to the Camp Australia Online Booking Form for Holiday Programs. Please complete the fields below to register your application to the selected holiday program. This information will enable us to process your registration and payment. Once this has been completed, we will confirm your place at the requested program.

If you have any questions or require assistance, please contact our Customer Service Team on 03-8851 4160

Please select the Holiday Program you would like to register for:

Please choose the number of children you wish to register for

How many children would you like to register for?:

1st Child

First Name:

Last Name:

Gender:

Date of Birth:

Select Date

Child CRN:

If your child suffers from asthma, allergies, any other medical condition or needs to have medication administered, you must send a copy of a medical management plan or additional information with your enrolment.

Asthma:

Allergies:

Dietary Restrictions:

Medication:

Medical Condition:

Parent/Guardian #1
(This person will receive the Account. If claiming Child Care Benefit, this person must also be linked to the Service)

Title:

First Name:

Last Name:

Email Address:

Street:

Suburb:

State:

Post Code:

Home Phone:

Work phone:

Mobile Phone:

Relationship to Child:

Date of Birth:

Select Date

Parent CRN:

Parent #2 / Guardian #2 / Or Other Emergency Contact

Title:

First Name:

Last Name:

Email Address:

Address Details:

Work Phone:

Mobile Phone:

Relationship to Child:

Court Orders:

Reason:

English:

Other Languages:

Medicare #:

Ambulance #:

Health Fund Name:

Health Fund Membership #:

Preferred Doctor:

Doctor's Phone:

Type of Credit Card:

Credit Card Number:

Name on Credit Card:

Please enter a value for Credit Card Expiry

Credit Card Expiry:

(month)

/:

(year)

Parent/Guardian Declaration

I the undersigned, approve of my child’s involvement in Camp Australia’s program and have read all conditions on this form.
I give permission for my children to participate in centre-based activities organised for the days my child will be attending, including watching G Rated videos/movies.
I authorise staff, in the event of accident or illness, to obtain all necessary medical assistance and treatment for my child and agree to meet any expenses attached to such treatment.
I acknowledge that my child will not attend the Service if suffering from an infectious or communicable disease.
Camp Australia does not accept any liability for personal injury, property damage or loss sustained by any participant as a result of his or her participation at the holiday program due to any cause whatsoever unless caused by the proven negligence of Camp Australia, its directors or employees.
I authorise staff to apply sunscreen to my child if I do not provide such.
I fully understand that if my child continuously misbehaves after guidance procedures have been followed, I will notified and my child may be removed from the program.
I agree to pay for the days my child is successfully enrolled in, regardless of whether my child actually attends.
I understand that non payment of fees for this service may result in my child’s exclusion from the program.
The information I have provided on this form is correct.
I have read and accepted the terms and conditions of the holiday porgram

Submit

Once you have completed the online registration form, click the submit button above. The form will be submitted to us for review and processing. Please wait while the form is saved.