Camp Application Form

* denotes required field

To apply for the next Transition Camp please complete this form. The Camp Committee will meet to allocate places shortly after the application close date. You will be notified by email on the outcome of your application.
1. Parent's full name:
2. Child's full name:
3. Address:
4. Phone number:
5. Email address (ensure this is correctly entered - all correspondence will be sent to this address):
6. Child’s date of birth (dd/mm/yyyy):
7. What is your child’s gender:
8. NDSS number*
9. Has your child attended a diabetes camp in the past:
10. If YES, which camp/s and when?
11. Diabetes Educator or Doctors Name:
12. Diabetes Educator or Doctors Address:
13. Does your child have any special dietary requirements:
14. Does your child have allergies or other illnesses:
15. Does your child have any other special needs:
16. How do you manage your diabetes?
17. Why do you want your child to attend this camp:
18. If your child is selected to attend camp, the $100 camp fee will need to be paid as a deposit to secure their spot. Their place is not guaranteed until we have received payment. If we do not receive payment at least 2 weeks before camp, their place may be released to someone on the waitlist
19. Do you need to apply for financial assistance?
20. The camp cost is $100. If you are applying for financial assistance how much of the $100 are you able to pay?

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