Camper Application – Step 1 – Feel the Magic – Empowering children to thrive from grief

I declare that the information provided by me on this application is true and accurate to the best of my knowledge and belief. I understand that misrepresentation or incorrect information provided may result in refusal of application or revocation of acceptance.*
- I understand and agree with the above statement and will complete this application according to these terms and conditions.
Title
Name*
First Name Last Name
Relationship to Camper*
Other Relation
Do you have a Referral Code?*
Referral Code
Are there any current court orders including parenting orders that we need to be aware of?*
- Yes
- No
Please provide information regarding current court orders
Applying for Camp Location*
- ACT
- Armidale
- Sydney
- Victoria
Camp Date Applying For*
Address*
Street Address Suburb State Post Code Country
Mobile*
Phone
Email*
Where do you work?*
What position do you hold?*

Camper Application – Step 1