Parental Consent Form
Please fill in a separate form for each child. Click on the Print button to print out a hard copy to return to the church office, or scan and email it back to
youth@citylife.church as soon as possible.
Place
Phillip Island Adventure Resort. 1775 Phillip Island Rd, Cowes. Phone: (03) 5952 2417
CYC The Island. 41-53 Church Street, Cowes. Phone: (03) 5952 2201
Purpose
EPIC Youth Winter Camp – 4 to 6 of July 2025
Time to be dropped off
Friday, 4 July 2025 at 4:30pm. Buses will depart at 5pm. Dinner provided.
Drop-off address
Knox - 1248 High Street Road, Wantirna South
Casey – Waverley Christian College (Narre Warren South), 20 College Drive, Narre Warren South
Manningham – Ted Ajani Centre, 284 Thompsons Road, Templestowe Lower
Whittlesea – 70 Kingsway Drive, Lalor
Time to be picked up
Sunday, 6 July 2025 at 4pm.
Pick-up address
Same as drop-off addresses
What to bring
Winter will be in full swing by this time so WARM clothes appropriate for outdoor activities. Also bring Bible, pens, sleeping bag, toiletries, towel (maybe even 2 to be safe). Bathers for activities involving water.
What we will be doing
Supervised or instructed camp activities will include: high ropes, flying fox, general camp games, archery, kayaking and ball games.
Participating Child's Name
..............................................................
Parent/Guardian Name
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I hereby grant permission for my child to attend, travel to and from, and participate in activities held over the duration of this camp offered by CityLife Church Inc (CityLife). I acknowledge and agree:
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The Camp will be conducted and supervised by CityLife and/or its representatives who may include EPIC Youth Staff Leaders (Representatives);
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There are inherent risks associated with the Camp, and while CityLife and its Representatives will take all reasonable steps to minimise those risks they cannot eliminate them completely;
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If CityLife or a Representative determines in their honest and reasonable opinion that my child has misbehaved and should be removed from the Camp, CityLife or a Representative may contact me to inform me of that determination and I agree:
- To immediately collect my child from the Camp, or arrange for someone to do so; or
- If I refuse to collect my child, for a responsible adult to drive my child home, in which case I am liable for and agree to pay to CityLife all reasonable associated costs;
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In the case of an accident, danger, emergency, illness or injury, CityLife or a Representative will take reasonable steps to contact me but may in any case take such steps as it considers reasonably necessary to protect my child’s health and wellbeing, including but not limited to:
- Evacuating or removing my child from the Camp; and
- Providing or sourcing medical care, transport or treatment, and I am liable for and agree to pay all costs associated with such medical care, transport and treatment;
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If my child is a Year 11 or 12 student, they may leave the Camp site during allocated free time for the purposes of visiting the beach or participating in activities scheduled by CityLife; and
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CityLife and its Representatives may take and use photographs or video footage of my child for promotional purposes.
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I understand that by registering my child for this event I give CityLife Church permission to take and use images and/or footage of my child for promotional purposes at,
- this event AND
- other EPIC events
To the maximum extent permitted at law I hereby release and discharge CityLife and all Representatives from and against any and all liability arising from or in any way connected to my child’s attendance at, travel to and from, and participation in any activity at, the Camp, except to the extent such liability arises by reason of gross negligence on the part of CityLife or its Representative.
Signature
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Date
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