Date of Birth
Siblings who reside with child (biological/otherwise)
Emergency Contact Name
Emergency Contact Phone
Foster Agency Name
Foster Agency Phone/Email
Child Safety Service Center
Child Safety Officer Name
Current Order (preference for children on Long term guardianship/second short term custody order who can remain with the program for up to 2 years)
Attach a copy of the Protection Order (if possible)
Current Contact Arrangements with Biological Parents (Supervised/Unsupervised)
Foster Agency Details (if relevant, Name/Centre/Contact details)
School/Kindy/Prep/Day Care Details (if relevant, Name/Centre/Contact details)
Therapist Details (if relevant, Name/Centre/Contact details)
Where did you hear about Little Stars Kids Camps?
Social MediaWord of MouthMagazine / AdvertisingOther - fill in details below
When children are enrolled we like children to attend all 4 camps per year.
24 February 201919 May 201911 August 20191 December 2019
Will the child be in your care on the above mentioned camp dates?
It is important that Little Stars Kids Camps has up to date information about your child’s health, so that in the unlikely case of injury/illness we are able to provide the most appropriate medical care.
You are required to advise Little Stars Kids Camps if the status of the child’s health changes after completing this form, or your child comes into contact with an infectious disease, (including chicken pox, conjunctivitis, gastro or influenza within TWO weeks of the program.) Children cannot attend camp if they have an infectious condition.
Dietary requirements (e.g. gluten free, lactose free, vegetarian etc)
Does your child have any specific issues surrounding food that would be helpful for our team to be aware of?
Diagnosed illnesses (e.g. post-traumatic stress disorder, autism, etc)
Allergies, sensitivities or reactions (e.g. asthma, bee stings, nuts, grass, hay fever etc)
Does the child have an epi pen?
Does the child use an asthma puffer?
Any pre-existing physical injuries/illnesses/ailments?
Any recent surgery?
Are there any physical, social or psychological ailments that may affect the child’s participation in an activity? (e.g. claustrophobia, fear of heights etc)
Is the child toilet trained?
Does the child require nappies/pull ups?
What (if any) assistance will the child need with toileting?
Special instructions regarding toileting
Name on Card
Do you have any other children in your care?
Does the child have siblings not in your care?
Would the child prefer a male or female adult companion for the camps?
Does your child have any particular triggers which may impact upon their behaviour/psychological or emotional state that we need to be aware of?
Do you have a behaviour management plan in place? Please set out details of any behaviour management plan which will assist us in caring for the child during the camp:
Do you give permission for photos to be taken of your child during camp (to be included in the child’s photo book and hand-made photo frame at the end of the day and provided to the child):
It helps us to know a bit about your child so we can personalise the camp experience. Do you have any further information you would like to share about the child applying to attend camp?
Little Stars Kids collects your personal information to administer our programs, including complying with our legal obligations and to allow our companions to get to know the camper better. We also may collect your personal information to promote and communicate with you about our initiatives. If you do not provide the information requested you will not be considered for a position as a camper. We may disclose where necessary, limited personal information to third parties that provide services to Little Stars Kids. We may also disclose your personal information to companions to enable them to get to know the child.
Corporate HouseLobby 1, Gasworks PlazaLevel 2, 76 Skyring TerraceNewstead QLD 4006
Phone: 07 3062 9455
Kerri Chard has worked with Little Stars Kids to create the trauma-based training program all tutors undergo. She is a leading voice in Child Protection with a background in psychology and over two decades of professional experience.
She has developed award winning interventions within the Education sector, assisting schools to better understand complex developmental trauma and support children in the education system as well as bringing trauma informed curriculums into the classroom.
Kerri is Queensland’s leading Trust Based Relational Intervention (TBRI®) practitioner, and is well known for her passionate yet pragmatic approach to the complex issue of Child Protection.
Lisa holds a bachelor of arts with a double major in psychology and a bachelor of law and graduate diploma in employment law. She is admitted as a Barrister and Solicitor of the Supreme Court of Queensland and has practised as a lawyer for over 20 years.
Lisa has experience in advocating for the rights of the child in a litigation role and a non -adversarial role and was nominated as a finalist in the Queensland Community Foundation Emerging Philanthropists Category in 2019 for her work with children who have experienced abuse and neglect.
Lisa is passionate about helping children who have experienced abuse and neglect through providing programs which support the emotional, academic and physical sense of wellbeing of children in out of home care in Queensland. Lisa was a partner in mid sized law firm for many years and subsequently ran her own legal practise for several years.
She has also sat on several boards and advisory committees pertaining to children and has undergone additional ad hoc training in the area of child protection and trauma and the developing brain. Lisa has a particular interest in improving educational outcomes for children in out of home care and giving children a voice that is currently not heard within the child protection system.
Randall is a Director at BDO Australia, an international accountancy firm, and has extensive experience in retail, particularly in the automotive sector but also more broadly with experience in food and beverage retail. His employment with a multi franchise dealership and a national automotive retail chain, as well as 15 years in chartered accounting, provides an excellent platform for specialist professional services. He is able to understand and support his clients with their operational and statutory requirements.
Randall is committed to making a difference in the lives of children living in care through the work of the Little Stars Kids and our Little Stars Kids Camps which provide so much Fun and laughter.
Kerrie has a background in marketing and communications and runs Pollen Communications.
Kerrie combines her bright and creative personality with her formal qualifications in integrated marketing communications producing results with an innovative edge. With more than 15 years’ experience across public relations, events and marketing, Kerrie has built a solid yet diverse clientele across the property, construction, retail, mining, tourism, health and fitness, not-for-profit and luxury product sectors.
A passionate and experienced communicator with a love for writing, Kerrie is passionate about using her skills to assist Little Stars Kids to build its presence to enable it to continue to support children in foster care.
Tristan is the Dealer Principal and Chief Operating Officer of the Keema Automotive Group in Queensland which operates over 5 sites across Brisbane and employs around 250 staff.
Tristan has an accounting background and was previously the Chief Financial Officer of the Keema Automotive Group.
Tristan has significant experience in financial matters and developing the strategic direction of the Keema Group.
Tristan is committed to making a difference in the lives of children living in care through the work of the Keema Childrens’ Foundation. He has been a Pyjama Angel with the Pyjama Foundation for several years, working with children in care to increase literacy and numeracy.
Megan has been an educator in the field of early childhood education for over 26 years. She is currently a teacher at Lady Gowrie Love Street Community Kindergarten. In 2014, the Queensland University of Technology acknowledged her for excellence in Mentoring Early Childhood Pre-service Teachers.
As teacher-researcher, Megan takes on an active role in researching relationships, friendships and the role of the teacher in the early learning environment. She has presented at the Lady Gowrie Conference, speaker at Gowrie Symposium, and was a key note speaker for the Jean Ferguson Memorial Lecture at Queensland University of Technology.
Megan has a particular interest in the role of trauma in the developing brain and early attachment. Megan also takes an active role in the Camp program and has been involved with the camp program as volunteer camp leader since 2016.
Katie Taylor and her husband have been fostering children for over ten years. In that time they have fostered respite, emergency and long term children. Katie has a passion for caring for kids with special needs and currently has 10 full time children in her care and one part time ranging from 7-16 years of age.
Katie has been involved with Little Stars Kids since it’s inception and is passionate about our programs and the huge impact that both the camp and cuddle cases program have on children living in foster care in Queensland. Katie also volunteers with Queensland Foster and Kinship Care as a delegate and in this role successfully supports and assists other carers to navigate what can be a very challenging system.
Katie brings a wealth of knowledge regarding the needs of foster carers and the needs of children living in foster care to our Board.