2026 Youth Camp Parent Consent Form • Emerge Youth

Emerge Youth Parent/Guardian Consent Form Camp 2026

The purpose of this consent form is to give permission for my child(ren) to participate in the activities of Emerge Church's Youth Camp, and to establish parental permission for the following activities, where staff or volunteers of the church are unable to make contact with the parent / guardian.

Parental/Primary Contact for the teenager must fill below

Details

DATE: Thursday 2nd - Saturday 4th July 2026

Location: 192 Williams Rd, Caboolture Qld (Hopepointe Church)

Price: $189

PAYMENT:

Direct Funds Transfer

Name: Emerge Church Warner

Bsb: 034077 Acc#: 569081

Ref: eycamp (first name initial & last name) E.G.: eycamp j smith

Cash or Card can be used on the day.

Full or final payment is required by July 4th unless prior approved with Pastor Jack.

CANCELLATION:

Once you have registered, if after 25th June you are unable to attend the camp a cancellation fee of $25 will be required to cover costs already incurred on your behalf. If you cancel after June 29th July your full camp fee will be required. Special consideration will be given under the discretion of Pastor Jack Elmendorp.

Your Name

First Name *

Last Name *

Parent/Guardian Name *

Parent/Guardian Phone Number *

Parent/Guardian Home Address *

Parents Email Address *

Childs Details

Childs First Name *

Childs Last Name *

Childs DOB *

Medical Information

Does your child have any medical conditions? *

Does your child require to take medication over camp? *

Tip: If yes, please provide all details of medications and times to take medication when you/your child arrive at registration

Paracetamol consent *

Tip: I give consent for my child to receive paracetamol if required

Dietary Requirements

Does your child have any dietary requirements? If yes, please specify *

If yes, please provide details

Drop Off/Pick Up

Emerge Youth Camp is from the 2nd-4th of July at Hopepointe Church in Moodlu. There will be a busses leaving from Emerge Church Warner, Redcilffe & Morayfield on the 2nd to drive youth to camp, and returning on the 4th to drop them back. I understand that Parents/ Guardians are responsible to drop off and pick up their children at Emerge Church Warner, Redcilffe & Morayfield before and after the bus pick up/drop off. I understand that if a child is not picked up by a parent / guardian at the end of the camp, a youth leader will attempt to contact the parent.

In the event that a youth leader is unable to make contact with me I give permission for a youth leader to drop my child(ren) home after youth if I cannot pick them up *

Select *

Emergency Contact Details

Full Name *

Phone Number *

Additional Information

Are there any custody arrangements or court orders that the church needs to be aware of?

Select *

If yes - please describe medical conditions

Parent/Guardian Consent

I give permission for my child/children to attend Emerge Youth Camp, July 2nd to July 4th In case of medical emergency, I understand that every effort will be made to contact the listed emergency contact. In the event that they cannot be reached, I hereby authorize and consent to any reasonable medical treatment deemed necessary by staff and leaders. I hereby release all staff and volunteers from any liability and costs incurred in case of accident and/or injury. I understand that if my child is misbehaving and not obeying reasonable camp rules, I will be contacted to come and collect my child/children or arrange alternative transport home, at my own costs.

I have read and agree to the parent consent form *

Select *