Full Name
Date of Birth
Address
Home Phone
Mobile Phone
Email
Shirt Size SMLXLXXLXXXL
Current Employer/Position
Previous Employer/Position
Personal Referee #1
Personal Referee #2
Contact Name
Relationship
You are required to advise Little Stars Kids’ Camps if the status of your health changes after completing this form, or you come into contact with an infectious disease, (including chicken pox, gastro or influenza ) within TWO weeks of the program.
It is important that Little Stars Kids’ Camps has up to date information about your health, so that in the unlikely case of injury/illness we are able to provide the most appropriate medical care.
Dietary requirements (If yes, please provide a description i.e. gluten free, lactose free, vegetarian)
Allergies, sensitivities or reactions (If yes, please provide a description: i.e. asthma, bee stings, nuts, grass, hay fever etc)
Do you have an epipen? YesNo
Do you use an asthma puffer? YesNo
Any pre-existing physical injuries/illnesses/ailments?
Any recent surgery?
Do you use an asthma puffer? Camp Buddy for a childFundraisingAssistance with activities at campCamp PhotographsCamp LeaderAdministration assistanceCamp NurseHelper at CampPacking Cuddle Cases
Are you committed to attending four day camps per year (if you have ticked Camp Buddy above)? YesNo
Are you committed to completing our online training? YesNo
Why do you want to be a volunteer?
Do you have any special skills or experience that may be of assistance to us at camp. (Ie dance instructor, sign language, face painting, musical skills, nurse etc.) YesNo
Where did you hear about Little Stars Kids Camps? Social MediaWord of MouthMagazine / AdvertisingOther
Are there any physical, social or psychological ailments that may affect your participation in an activity? (i.e. claustrophobia, fear of heights etc)
Attach a copy of your current first aid certificate or any other medical qualification (if applicable)
Do you take any regular medication that you will be bringing to the program? (i.e. high blood pressure medication, contraceptive pill, insulin, anti -histamines, vitamins, etc)
It is your duty of care to hand in any of your medication at the commencement of camp to the camp leader to ensure that it is appropriately locked away for the duration of the camp.
Do you give permission for photos of you being placed in any LSKC publicity? YesNo
Attach a legible copy of your Blue Card (If you do not currently have a blue card, we will forward you the relevant form with our details once we receive your volunteer application, and we will lodge on your behalf)
Attach a legible form of photo identification (i.e. license, passport)
Attach a second legible form of photo identification (i.e. license, passport)
Have you ever been charged or convicted of any offences relating to children, or any sexual offences? YesNo
Little Stars Kids collects your personal information to administer our programs, including complying with our legal obligations and if you are a Companion, to allow families to get to know you better. We may also collect your ‘sensitive information’, such as criminal history information obtained through a Police Record Check or Working with Children Check for the same purpose. 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 volunteer. We may disclose your personal information to third parties that provide services to Little Stars Kids’ Camp. If you have volunteered as a Companion, we may also disclose your personal information to families to enable them to get to know you. Our Privacy Policy located at www.littlestarskids.org.au contains information about: (i) how you can access and correct your personal information; and (ii) how to lodge a complaint regarding a breach of the Australian Privacy Principles and how we will handle such a complaint.
