GUPPY DEVELOPMENT CAMP

4/5 NOVEMBER 2017

CHAMPION LAKES REGATTA CENTRE

CLBC GUPPY DEVELOPMENT CAMP 4/5 NOVEMBER 2017

ENROLMENT FORM

Please PRINT

All forms and payment must be received by Tuesday 31 October

Forms can be posted to PO Box 24 Armadale 6992 or

emailed to ( preferred method)

$30 Payment to be made to: Champion Lakes Boating Club

BSB: 633 000

Acc: 143982619

Reference: guppySURNAME

Guppy Paddlers Name

______Birth date: ______

Address______

Gender: ❑Male ❑Female

Paddling Experience...... ❑ Club member or some experience ❑ Beginner ( This is to help us form compatible groups)

Parent Guardian #1 Name:______

E-mail: ______

Address:______State______Postcode______

Home Phone: ______Mobile Phone:______

Emergency Contact: Name______

Mobile Phone______

MEDICAL INFORMATION

1.  Does your child have specific Dietary needs: ______

2.  Does your child have a medical condition, chronic or recurring, which may require emergency action while he/she is at Camp?

List:______

______

3. Does your child have any known food allergies? eg. peanuts.

Please provide details______

4. Is your child on any daily medications? ❑Yes ❑No

Please list: ______

6. In the event of a medical emergency, CLBC volunteers will call an ambulance (at the parents expense) and notify a parent immediately ❑I agree

Parent Signature: ______Date: ______

Swimming Disclaimer

Canoeing WA requires paddlers can swim a minimum of 50 m. My child can swim 50m.

Parent Signature: ______Date: ______

GENERAL INFORMATION

Food/Meals Arrangements

Afternoon Tea on Saturday and Morning Tea on Sunday will consist of fruit, cracker biscuits, cheese, vegetable sticks and dips.

Saturday Dinner…Homecooked and delivered to camp: Spaghetti Bolaignese and salad with icecream and brownie dessert

Sunday Breakfast…..Baked beans and toast or cereal with fruit and yoghurt

Sleeping arrangements

Girls and boys will sleep separately in our two separated boatsheds, on air mattresses, on the floor/carpet. Both sheds are lockable. The children will have an adult female and male supervisors with current WWC cards sleep with them (plus several volunteer parents). An adult from each shed will accompany a child to the adjoining toilet block, should they need to go during the night.

There will also be at least one adult with Senior First Aid qualifications on site throughout the camp.

Showers

There are two separate lockable showers, situated in the toilet block. The children will have a designated time to shower.

Camp Program ( Still to be finalized)

Saturday 4 November

1.30pm....Arrive

Sunday 5 November

4.15-4:30…Conclusion of camp

CAMP RULES

1.  Any anti social behaviour will result in time out from an activity and after continual anti social behaviour a parent will be notified to pick up their child.

2.  No child is allowed to leave the boatshed after lights out without the supervision of an adult(to go to the toilet)

WHAT TO BRING

Two sets of kayaking clothes

Pyjamas + other warm clothes

Towel and toiletries

Sleeping Bag

Pillow

Air mattress or mat

Plastic Cereal bowl and Plastic Dinner plate

Knife, fork and spoon

Please mark all items