Camp Application Form – Card Payments | Kids of Gold

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This form is for Card Payments only.

If you’d like to pay Bank Transfer or Cheque please use the form here >>

Camp Application Card Payments

Camp Application Form - Card Payments

February Friday 7th to Sunday 9th 2025

Enter number of children in this application:

Child Details - 1

Please complete all information about this child.

First Name

Last Name

Gender

Male

Female

Grade at School

Date of Birth

School Attended

Dietary Requirements?

Yes

No

Dietary Details

Bed Wetting?

Yes

No

Further bed wetting info

Medicare Number

Permission for First Aid to be given at camp as required:

Yes

No

Permission for Medical Treatment to be given at camp as required:

Yes

No

Permission for Panadol to be given at camp as required:

Yes

No

History

If there is some particular area where you would love to see confidence or self-esteem increased in your child, it would help us to know, so that we can work on that during the camp. Please let us know if your child needs special understanding. All information will be kept private and confidential.

Areas to Work on

Special Skills, Abilities or Interests:

Do you have a friend you want to be in the same group with?

Child Details - 2

Please complete all information about this child.

First Name

Last Name

Gender

Male

Female

Grade at School

Date of Birth

School Attended

Dietary Details

Dietary Requirements?

Yes

No

Bed Wetting?

Yes

No

Further bed wetting info

Medicare Number

Permission for First Aid to be given at camp as required:

Yes

No

Permission for Medical Treatment to be given at camp as required:

Yes

No

Permission for Panadol to be given at camp as required:

Yes

No

History

If there is some particular area where you would love to see confidence or self-esteem increased in your child, it would help us to know, so that we can work on that during the camp. Please let us know if your child needs special understanding. All information will be kept private and confidential.

Areas to Work on

Special Skills, Abilities or Interests:

Do you have a friend you want to be in the same group with?

Child Details - 3

Please complete all information about this child.

First Name

Last Name

Gender

Male

Female

Grade at School

Date of Birth

School Attended

Dietary Details

Dietary Requirements?

Yes

No

Bed Wetting?

Yes

No

Further bed wetting info

Medicare Number

Permission for First Aid to be given at camp as required:

Yes

No

Permission for Medical Treatment to be given at camp as required:

Yes

No

Permission for Panadol to be given at camp as required:

Yes

No

History

If there is some particular area where you would love to see confidence or self-esteem increased in your child, it would help us to know, so that we can work on that during the camp. Please let us know if your child needs special understanding. All information will be kept private and confidential.

Areas to Work on

Special Skills, Abilities or Interests:

Do you have a friend you want to be in the same group with?

Parent / Guardian Details

First Name

Last Name

Address

Address Line 1

Address Line 2

City

State

Post Code

Emergency Number

Alternate Emergency Phone Number

Email Address

I understand that by allowing the above children to attend “Kids of Gold” Camp, that all staff and volunteers cannot be held liable for any accidents or injuries that may occur during the duration of the camp.

Payment - Camp Fees

Please select whether you are paying Full Camp Fees or Deposit per child.

Camp Fees

Deposit $35 Per Child

Full Camp Fee $85 Per Child

No payment items has been selected yet

Kids of Gold

A.B.N 57 327 231 835
Registered Incorporated Association No. A0050015Z

Registered Address:
323 Monbulk Road
Silvan Victoria 3795

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Bookings

0403 271 987 or 0418 170 027

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