1
HeartKids NSW Family Camp Documents
HeartKids NSW Regional Family Camp
HeartKids NSW would like to invite you to a 3 day family camp at the
Lake Burrendong Sport and Recreation facility from Friday 13th
November to Sunday 15th November. This camp will give you and your
family a chance to enjoy some fun activities, whilst connecting with
other families that are also affected by Childhood Heart Disease.
This kit includes important documents regarding the HeartKids NSW
Family Camp, including forms that are required to be returned to both
HeartKids NSW, and the facility where the camp will be held, in order
to secure your place. Please ensure you read through this document
thoroughly, and contact us if you require clarification on any of the
information contained within.
HeartKids NSW, PO Box 170, Westmead Hospital, Westmead NSW 2145
E: [email protected] W: www.heartkidsnsw.org.au
P: (02) 9631 2600
2
HeartKids NSW Family Camp Documents
Booking Form Family Camp Lake Burrendong
13th-15th November 2015
Family Name_____________________________________________
Address__________________________________________________
__________________________________________________________
Email_____________________________________________________
Phone Number___________________________________________
Name (Please
complete for each
person attending)
Age (if Child)
Dietary
Requirements
Bookings will only be confirmed once this booking form has been received
along with medical forms and signed code of conduct. All forms will need to
be completed and received by our office no later than Monday 24th August
2015, before we can confirm your booking.
A detailed information pack will be sent once the above documentation has
been received.
Please return forms to : Mardi Aplin, HeartKids NSW, PO Box 170, Westmead
NSW 2145 or scan and email to [email protected]
HeartKids NSW, PO Box 170, Westmead Hospital, Westmead NSW 2145
E: [email protected] W: www.heartkidsnsw.org.au
P: (02) 9631 2600
3
HeartKids NSW Family Camp Documents
Family Camp
Privacy Statement
Why We Need Your Information
In the course of managing Family Camp, HeartKids NSW collects and stores personal and/or health
information about campers, volunteers, employees and their families. HeartKids NSW collects, uses
and sometimes shares this information with others to provide a safe and supportive environment for
everyone at camp.
You do not have to provide us with all of the information we request in the forms for Family Camp,
but if you do not, it could affect your ability to attend camp or HeartKids NSW’s ability to provide a
safe and supportive camp experience.
What is Personal Information & Health Information
‘Personal information’ is any information which can identify a person, including their name and
address. ‘Health information’ is sensitive personal information which includes information about a
person’s health, disability, and use of health services. Sometimes, details about a person’s health or
medical history can identify them, even if their name is not attached to the record/details. This is still
‘personal information’. Both personal information and health information are regarded as
confidential information by HeartKids NSW.
How We Manage Your Information
HeartKids NSW manages and stores your information in compliance with the National Privacy
Principles and Privacy Amendment (Private Sector) Act 2000.
Information disclosed on online forums or other interactive media is considered by HeartKids NSW
and the common law to be public information and may not be subject to protection under the Act.
HeartKids NSW is not responsible for the privacy practices of web sites external to HeartKids.
Disclosing Information to Others
HeartKids NSW will not disclose your personal information or health information to anybody else
unless we are required to do so by law – for example if the information is needed in an emergency
or for law enforcement. HeartKids NSW may disclose personal information to a third party if the
disclosure is necessary to prevent or lessen a serious and imminent threat to your health and safety
or that of another person.
Access to Your Information
You have a right to access your personal and health information or the personal and health
information. You can also request amendment to that information if you believe it is incorrect. You
also have the right to make complaints about the information handling practices of HeartKids NSW
or breaches to your privacy by HeartKids NSW.
Contact Information
For further information about how we handle your information or to request access to the
information collected about you, please contact HeartKids NSW
Phone: (02) 9631 2600
HeartKids NSW, PO Box 170, Westmead Hospital, Westmead NSW 2145
E: [email protected] W: www.heartkidsnsw.org.au
P: (02) 9631 2600
4
HeartKids NSW Family Camp Documents
Email: [email protected]
Postal Address: PO Box 170, Westmead Hospital, Westmead NSW 2145
HeartKids NSW, PO Box 170, Westmead Hospital, Westmead NSW 2145
E: [email protected] W: www.heartkidsnsw.org.au
P: (02) 9631 2600
5
HeartKids NSW Family Camp Documents
Family Camp Code of Conduct for attendees
Introduction
Family Camp provides an opportunity for heartkid member families to meet and
share experiences with other heartkids families. In order for camp to be a safe place
and an enjoyable experience for everyone, campers must be aware of, and
comply with the code of conduct. We ask that all heart kids, siblings and their
parents/guardians read this code of conduct together before camp.
Code of Conduct
I will...
 Treat others the way I would like to be treated, with respect and
consideration
 Be mindful of the privacy of others
 Cooperate with camp and HeartKids and follow instructions
 Keep my room and surrounding areas clean and tidy
 Leave valuables at home, as I understand that HeartKids will not be held
responsible for any loss or damage
I will not...









Be mean or rude to others, put them down, bully or harass them
Be violent or aggressive
Deliberately hurt the feelings of others
Use foul or explicit language
Demonstrate suggestive or sexual behaviour
Trespass, steal, vandalise or graffiti
Bring any type of weapon to camp
Bring or consume illegal drugs
Discipline a child that is not part of my immediate family
I understand that if I do not follow this code of conduct, the following could happen
at the discretion of HeartKids NSW:
be asked to go home early.
Parent/Guardian 1:
Signature:____________
Date:___________
Parent/Guardian 2:
Signature:____________
Date:___________
HeartKids NSW, PO Box 170, Westmead Hospital, Westmead NSW 2145
E: [email protected] W: www.heartkidsnsw.org.au
P: (02) 9631 2600
6
HeartKids NSW Family Camp Documents
HeartKids NSW
Child Safe Child Friendly Policy
Introduction
HeartKids NSW wants both parents and their children who participate in its activities
to have a safe and happy experience. HeartKids NSW supports and respects
families, children, young people, staff and volunteers.
1. Participation of families with Children and Young People
HeartKids NSW supports the participation of the whole family. We plan ways of
including everyone in activities. We listen to their views, and involve them when we
make decisions as much as possible.
2. Supporting Safe Environments for families attending Family Camp.
3.1
Venues
All venues selected for Family Camp have been assessed for their safety and
appropriateness by HeartKids NSW or its representatives. HeartKids NSW endeavours
to eliminate sources of harm in the physical surroundings or positively manage them.
3.2
Accommodation
Each family are allocated separate rooms with private facilities. No staff member or
volunteer should be co-located in the same room as another family.
3.4
Travel
All families are responsible for their own travel arrangements to camp. It is the
families responsibility to contact a HeartKids representative if they incur any
difficulties or delays to their arrival.
3. Supporting staff and volunteers working with or assisting with activities where
children are involved
HeartKids NSW takes reasonable steps to ensure that it engages the most suitable
and appropriate people to work with children and young people.
Strategies to Minimise Risk
Any incidents occurring at camp are reviewed at the end of camp and strategies
are developed to minimise the risk of the incident occurring again. Specific policies
and procedures have been developed to minimise identified or potential risks.
HeartKids NSW, PO Box 170, Westmead Hospital, Westmead NSW 2145
E: [email protected] W: www.heartkidsnsw.org.au
P: (02) 9631 2600
7
HeartKids NSW Family Camp Documents
HeartKids NSW Incorporated
Photograph/Image Consent Form for Minor
Photograph/Image Use by HeartKids
This consent form is to inform you about how HeartKids NSW uses photos and video images and to seek permission to use your
child’s photograph and/or video.
HeartKids NSW from time to time produces promotional material for the purposes of raising awareness of childhood heart
disease, and of HeartKids and the support, research and advocacy services we provide across Australia.
Employees, agencies and individuals working on behalf of HeartKids NSW, and volunteers of HeartKids NSW take photographs
and video of heartkids for the following reasons:
 Advertising and promotions, such as posters, video, displays, online advertising, radio, social media or television, on the
HeartKids website, editorials, newspaper articles
 Publications, such as brochures, flyers, annual reports, newsletters
 Memorabilia, such as a slideshow, video, scrapbook and a Facebook page.
HeartKids NSW would like to use and reproduce in print form and/or electronically, content which may include
photographs/images/video of your child for the above purposes and is seeking your consent to do so.
HeartKids acknowledges the valuable contribution made by you, your family and your child to support us in our endeavours.
When giving your permission, you should be aware that any information published on the internet is accessible to millions of
users and will be indexed by search engines and that it may be copied and used by any web user. This means that once an image
is published on the internet HeartKids NSW has no control over its subsequent use and disclosure.
You can gain access to the photographs or withdraw your consent at any time by contacting HeartKids NSW
Phone: (02) 9294 0800 [email protected] Postal Address: PO Box 170, Westmead Hospital, Westmead NSW2145
Permission for Photograph/Image Use
Please tick those boxes that apply:
□
I am legally authorised to give this consent
□
I grant permission for photos/images of my child/ward to be used in advertising and promotions, publications, memorabilia
(if you tick here you do not need to tick the rest)
□
□
□
I grant permission for photos/images of my child/ward to be used in advertising and promotions
I grant permission for photos/images of my child/ward to be used in publications
I grant permission for photos/images of my child/ward to be used in memorabilia
Conditions and Limitations
Please tick those that apply:
□
I do not grant permission for my child/ward’s name to be used in association with images and/or recordings:
□
The image is subject to the following cultural considerations (please specify):
□
Image use is subject to other restrictions (please specify):
Consent
Child’s Name:
DOB:
Name of Parent, Guardian,
Legally Authorised Person:
HeartKids NSW, PO Box 170, Westmead Hospital, Westmead NSW 2145
E: [email protected] W: www.heartkidsnsw.org.au
P: (02) 9631 2600
8
HeartKids NSW Family Camp Documents
Signature:
Date:
HeartKids NSW, PO Box 170, Westmead Hospital, Westmead NSW 2145
E: [email protected] W: www.heartkidsnsw.org.au
P: (02) 9631 2600
9
HeartKids NSW Family Camp Documents
Dear Parents and Guardians
Your child is about to attend a Sport and Recreation school camp at Lake Burrendong Sport
and Recreation Centre organised through HeartKids NSW. Prior to the camp all students
must complete a Medical and Consent Form.
The information that Sport and Recreation needs about your child includes:
- medical conditions
- food related allergies
- special diets
- medication
- emergency contact details.
Sport and Recreation needs you to complete this form on behalf of your child. The form is
available online and is easy to complete. Once you submit the form it is sent directly to the
Centre so the staff can prepare for your child's visit.
It is vital that you enter the following details to complete the online form:
Booking Number 0464466
Booking Start Date 13/11/2015
Booking Venue Lake Burrendong Sport and Recreation Centre
Please complete the Medical and Consent Form online at
www.dsr.nsw.gov.au/schoolcampmedical form by 23/10/2015
Regards
HeartKids NSW
HeartKids NSW, PO Box 170, Westmead Hospital, Westmead NSW 2145
E: [email protected] W: www.heartkidsnsw.org.au
P: (02) 9631 2600