Junior Beach Bumz (JBUMZ)
Jervoise Bay Sailing Club
Saturday 20th February 2016
Junior Beach Bumz (JBUMZ)
Jervoise Bay Sailing Club
Saturday 20th February 2016
01st February 2016
Dear Parents
Overleaf is a consent form which must be completed in order for your child to participate in the Junior Beach Bumz Camp
to be held at Jervois Bay Sailing Club on Saturday the 20th February 2016. The camp will be run with a priority focus on
the following attributes;
 Team Building
 Inclusiveness
 Getting to know each other and having FUN
There is an array of activities both in and out of water that have been organised to support the key items mentioned
above. At this stage it is looking to be a jam packed afternoon and evening full of fun, games and chill out periods.
To support us in our Duty of Care to your child, it is important to note any items of concern regarding your child's health or
diet in the spaces indicated on the form.
Completed and signed consent forms must be returned one week prior to the Camp so that final numbers and dietary
requirements can be effectively catered for.
What to Bring:
 Enough clothes for 2 days, warm clothes for night
 Small tent or Swag as we will be camping on the grassed area
 Sleeping bag or Doona
 Pillow
 Bathers and towels (include a rashie if possible)
 Closed in footwear (i.e. trainers) as these are required for several activities
 Hat and sunglasses
 Torch
 Sunscreen lotion
 Plastic bags (for wet or dirty clothes)
 Soap and deodorant (no smelly armpits please!)
 Plastic drink bottle
 A positive attitude
 Small back pack
 Snacks for evening times (be prepared to share!)
What not to bring:
Accommodation is camping on a grassed area; our advice is not to bring the following items as we cannot guarantee the
safety of them:
 Cd players, IPods, Gameboys etc.
 Expensive jewellery
 Large amounts of money
 Mobile phone
Weekend Supervision:
There will be ample supervision over the weekend with a minimum two males and two females present at all times, the
members of the Youth Active Council will be facilitating some peer to peer leadership activities as well over the weekend.
Thanks for your cooperation.
Craig Ashworth (Ashie)
Director of Youth Development, Coogee Beach SLSC
Junior Beach Bumz (JBUMZ)
Jervoise Bay Sailing Club
Saturday 20th February 2016
Consent Form
I give permission for my child to take part in all supervised activities at the Junior Beach Bumz Camp.
Nippers Name: …………………………………………...
Age: ………...
Age Group: ………………………
Parent/Guardians Signature…………………………………………………………………….
Date…………………………………………………………………………………………….….
Parents Contact Numbers: ……………………………………………………………………………..
Emergency Contact Number (if different from above) ……………………………………………….
Doctor (name)…………………………………………….…..
Phone No: …………………………
Medical Concerns (Please state)………………………………………………………………………..
………………………………………………………………………………………………………………
Common Signs or Symptoms: ………………………………………………………………………….
………………………………………………………………………………………………………………
Dietary requirements (E.g. vegetarian)…………………………………………………………............
……………………………………………………………………………………………………………….
Any known allergies: ………………………………………………………………………………………
Does your child have any conditions that will prevent them from participating in any physical activities?
………………………………………………………………………………………………………………………………………
………………………………………………………………………………………………………………………………………
………………………………………………………………………………………………
I hereby authorise the obtaining on my behalf of such medical assistance as may be required in the event of
an accident or illness; I authorise the administering of such medical treatment including the use of aesthetic as
may be deemed necessary by the medical officer attending. I agree to pay the cost of any such medical
assistance and any associated costs and expenses and to reimburse Coogee Beach SLSC Inc. for any costs
or expenses incurred.
Signature (parent or guardian)……………………………………………… Date: …………........................
Junior Beach Bumz (JBUMZ)
Jervoise Bay Sailing Club
Saturday 20th February 2016
BEACH BUMZ CAMP - ENTRY AND PAYMENT Details
Please note that all camp fees are to be paid to the Club via the online payment system using the
following below. This ensures that we have an accurate record of payments made for each
competition.
First: type the following link into your web browser
https://pnpnet.qvalent.com/OnlinePaymentServlet?cd_community=SLSA&cd_currency=AUD
or, search for SLSA Online Payment Gateway in Google
Then:
1.
2.
3.
4.
5.
6.
Type Coogee Beach Surf Life Saving (WA) in the “Select Entity to Pay” section.
Select “Other” in the “Transaction Type” field.
Type “Junior Beach Bumz Camp 2015/16” and the attendees name into the “Complete
name / Meaningful payment details”.
Enter the dollar amount in the “Amount” field. Fees are $50.00 (includes GST) for each
attendee who must be fully paid up active members of the club in the Under 10 to Under 13
Age Groups.
If you are paying for more than one attendee complete a separate line (up to 5) on the same
payment.
You will receive an email receipt which you need to forward to the Director of Youth, Craig
Ashworth (Ashie) [email protected] advising him of the following details:
a. Attendees name
b. Attendees age
c. Details of any medical conditions
d. Details of any dietary requirements
e. Parent’s name and contact details
Please note that camp fees MUST be paid prior to the 16th February so that total numbers can be
confirmed and catering can be organised.