HSC Leader Registration

HSC Leader Registration

General Information

Full Name
Tag Name (ie Jess rather than Jessica - no nicknames please)
Gender Age DOB
Home Address
Postal Address
Phone Mobile
Medicare Number
Current Church Attending
Email Address
Do you have a current Blue Card?
Card Number: Expiry:
I have a current first-aid certificate

T-Shirt

I need of the following size shirt

Emergency Contact Information

Contact Name
Phone

Worship Team

I would like to WORSHIP LEAD.I would like to SING.I would like to PLAY an instrument.
Instrument I will be bringing my instrument to camp.

Medical Information

Are you currently taking any medication?
What medication?
What condition is the medication for?
Dosage & details for administration:

Special Dietary Needs & Allergies

Do you have any special Dietary Requirements?
Do you have any allergies?

Comments or Questions?

Written by Jonathan McClintock