Young Carers WA Camp Application
13 November 2018
Dear Young Carer & Family,
Thank you for your interest in attending the Young Carers & Telethon Eco Adventure Camp for young carers who are aged 13 to 17. This is a 2 night/ 3 dayand it will run from Wednesday the 30th of September until Friday the 2nd of October 2015 at the beautiful Boshack Outback Getaway camp in Bolgart.
Activities will focus on “living with nature in the Australian Outback”. Young carers will have the opportunity to learn about traditional Aboriginal culture with activities such as Aboriginal Dreamtime and Didgeridoo Playing. They’ll also learn how Australia’s early settlers lived with activities such as Orienteering and Raft Building.
This camp has limited places. To apply, please fill in all of the following fields and the Consent Form and return these by Monday the 24th of August 2015. If this form has been posted to you, a Reply Paid envelope will be included. Please know that all the information that you provide us will be kept private and only shared with the other camp facilitators. This camp will be facilitated by the Young Carer Team from Carers WA. Any information shared with Telethon for reporting purposes will not identify people by name. We strongly encourage young carers from an Aboriginal and/ or Torres Strait Islander background to apply.
We will advise young carers and their families of the outcome of their application on Monday the 31st of August.
Please do not hesitate to call a Young Carer Team member on 1300 227 377 or email if you would like any further information.
We wish you all the best with your application! Don’t forget that even if you’re not successful on getting in to this camp, you can still join us for one or more of the fantastic young carer events throughout the year. Stay up to date with what’s happening at Young Carers WA by logging on to our website and be the first to hear about upcoming events and camps by liking our Facebook page ‘Young People Who Care-Young Carers WA’.
Warm regards,
Jodie Ronan & Sam Cheney
Young Carers
Carers WA
Name:Address:
Postal Address:
(If different to above)
Home Number:
Mobile Number:
Email Address:
Date of Birth: / Age:
T shirt size: / (please let us know if this is an adult or child’s size) / Hat size:
Do you have Aboriginal background? / Do you have Torres Strait Islander background?
Which country were your parents born in?
Which country were you born in?
How long has your family been in Australia for?
Do you speak a language other than English at home?
(Please specify)
Who do you care for? (your relationship to the person eg. daughter ) What type of care do they require (include what their disability, chronic and or mental illness is)?
______
______
______
______
How many hours do you spend caring a week?
Under 20 20 to 39 hours 40 or more hours
Duties preformed in caring role:
Medication Food preparation
Positive Behaviour Management Personal Care
Medical appointment assistance Therapy assistance
Emotional support Budgeting
Household cleaning.
Please list any other duties preformed in the caring role:
______
______
Tell us about your caring role and how it impacts on you. (No more than 100 words)
______
______
______
______
______
______
What other support do you receive? (This could be support from an organisation such as counselling, help with the housework. This could also be support from other family members, such as a parent, or perhaps you stay with relatives in the school holidays for a break.)
______
______
______
______
There will be a reunion event at Adventure World on Saturday the 7th of November. Transport will be provided between Perth and Bibra Lake. Will you be attending?
Yes No I will let you know
Do you live in a regional or remote area? If yes, which area?
Yes No Area: ______
If yes, do you require regional travel assistance?
Yes No