APPLICATION / INDEMNITY FORM
Please complete in BLOCK LETTERS and return to Scripture Union
The parent or guardian, by signing this document, warrants that he/she has read, understood and agrees to the terms and conditions below: The participant, named below, has my permission to participate in all activities on camp. Although I understand that every care is taken to ensure his/her safety, I am aware that attendance is at their own risk. I hereby agree to indemnify Scripture Union, Sumcay, the appointed leaders, associates and volunteer staff, and to hold them harmless in respect of any liability for any injury, loss or damage or expenses of whatever nature to any person or property howsoever caused. I also hereby authorise the organisers to administer appropriate First Aid and to arrange for medical treatment or hospitalisation in case of emergency. I shall not allow the applicant to leave for the camp unless his/her health is in every way satisfactory.

Surname:   .............................................................................................................

First name:  ............................................................................................................

Postal Address:......................................................................................................

.............................................................................................. Postal Code: ...........

School:...........................................................................................  Grade: ...........

Age: .....................           Sex: Male / Female

Parent's Initials & Surname:............................................... Tel: ........................

Are you on any Special Diet? (Specify) ..........................................................

Any Allergies (Specify) .......................................................................................

Known medical conditions: (e.g. asthma,
allergies, special medication needs): ..............................................................

Name of one friend you would
like to stay with (no promises):  .........................................................................


Signature (Parent) .............................................................................................

Date: .....................................................................

I enclose my full fee of R350  [    ]    OR my Booking Fee of R100  [    ]
and R ........................  as a donation towards a less fortunate camper.

The applicant will be using the following stop for transport to and from the camp:
....... Uitenhage Station     ........ Hallack Road, Mill Park  
....... Uitenhage Primary    ........ Korsten Library
....... Own Transport           ........ Ted's Garage New Brighton

PAYMENT OF FEES: All applications must be accompanied by proof of payment. Cheques made payable to 'Scripture Union'. If the full fee is not sent with the application, a non-refundable deposit of R100 must be enclosed. The balance must be paid by 15th November 2011. No camp fee will be accepted at camp. A kit list and travelling instructions will be sent on receipt of application. No child will be allowed to board the bus unless they have booked a place and must use the bus stop chosen.

SCRIPTURE UNION DETAILS:
1 King George's Road, Mill Park. Port Elizabeth
• Tel: 041 374 3164 • Fax: 041 374 4645
paul@su.org.za

BANKING DETAILS:
Scripture Union Algoa • Standard Bank Rink Street (050417)
Cheque Acc. No. 080281613.
Please use child's name as reference.


Every thing you need to know about Scripture Union.

Scripture Union is a world wide interdenominational youth movement. SU camps are planned to give young people a fun Holiday under experienced leadership. The programme is carefully supervised and care is taken to ensure the health and safety of the campers. There is trained leader for every 5-8 campers.

Swimming: is always under supervision

First-Aid: A well equipped medical box is at camp, and first aider. However, doctor's fees and prescriptions are charged to the parent/s.

Lost Property: will be held at the SU office for three weeks following camp. After this time, unclaimed lost property will be donated to charity. To avoid losses please mark your Child's clothing clearly.