Online Camper Application 2020 Expression of Interest - Campers To express an interest for your son, daughter or ward to attend the 2020 ICHC, please complete the form below. Once a decision has been made about the ICHC, a member of the ICHC Nursing Team will be in contact to assess suitability and continue the application process. Child DetailsChild's Name* First Last Mailing Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Name of School*Contact number of School*Email of school/suitable teacher (if available) Date of birth* Date Format: DD slash MM slash YYYY Gender*MaleFemaleOtherAge*Child's weight (kg)Child's height (cm)Disability*Photo (not required)Can't find a photo right now? No worries - you can send one later.General InformationPhone Number*Alternate Phone NumberEmail* Has your child attended the Ignatian Children's Holiday Camp before?*NoYesUnsureYear(s) :Has your child been to any Sony camps before?*NoYesUnsureWhich camps? Which years? :How often do you get respite?*DailyWeeklyMonthlyFamilyOtherReason you would like your child to attend the camp*Name of person recommending your child to camp* First Last Your relation to the child*Permission to contact your child's school to obtain information to support your application :*I agreeI do not agreeMedicalDoes your child suffer from : (Tick all that apply) Anaphylaxis Asthma Food Allergies Other Allergies Epilepsy Diabetes Does your child take regular medication?*YesNoMedications :Does your child require a special diet?*YesNoSpecial Diet :How much of what is being said does your child understand?*Very littleNearly allEverythingDoes your child :*Wear NappiesOnly require assistance with toiletingDoes not require any assistanceHow many times does your child wake during the night?*A couple of times a nightOnce a nightOccasionallyNeverHow often does your child swim?*Once a weekMonthlyRarelyNever / Does not like waterWhen your child has difficult behaviour, at home, on outings and at school, tell us the methods you use to support themA nurse will phone you to get further medical and care information ICHC - NURSING TEAM ichc@riverview.nsw.edu.au St Ignatius' College, Riverview Tambourine Bay Road, Lane Cove NSW 2066 Phone : 0448 450 320 Web : https://ichc.riverview.nsw.edu.auICHC is bound by the Privacy Policy of St Ignatius' College, Riverview. I acknowledge and accept the privacy policy* Yes
