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Online Camper Application

Expression of Interest - Campers 2025

To express an interest for your son, daughter or ward to attend the 2025 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 Details
Child's Name*
First Middle Last
Mailing Address*
Street Address Suburb / Town Postcode
Date of Birth*
DD slash MM slash YYYY
Country of Birth*
If born in Australia, City/Town (insert n/a if not born in Australia)*
Age*
Gender*
- Male
- Female
- Other
Is the child identified as Aboriginal or Torres Strait Islander?*
Background
- Aboriginal
- Torres Strait Islander
- Both
- Neither
Child's weight (kg)
Child's height (cm)
Disability*
Photo (not required)
Max. file size: 50 MB.
Can't find a photo right now? No worries - you can send one later.
Parent/Carer Information
Parent/Carer Name*
Full name
Parent/Carer Phone Number*
Alternate Phone Number
Parent/Carer email*
Medical
Does your child suffer from : (Tick all that apply)
- Anaphylaxis
- Asthma
- Food Allergies
- Other Allergies
- Epilepsy
- Diabetes
Does your child take regular medication?*
- Yes
- No
Medications :
Does your child require a special diet?*
- Yes
- No
Special Diet :
How much of what is being said does your child understand?*
- Very little
- Nearly all
- Everything
Does your child :*
- Wear Nappies
- Only require assistance with toileting
- Does not require any assistance
How many times does your child wake during the night?*
- A couple of times a night
- Once a night
- Occasionally
- Never
How often does your child swim?*
- Once a week
- Monthly
- Rarely
- Never / Does not like water
When your child has difficult behaviour, at home, on outings and at school, tell us the methods you use to support them
Additional Information
Has your child been to any Sony camps before?*
If yes, which year(s)?
Has your child attended the Ignatian Children's Holiday Camp before?*
If yes, which year(s)?
How often do you get respite?*
Reason you would like your child to attend the camp*
Name of person recommending the child to camp*
Full name
Recommending person's relationship to the child*
Name of School*
Contact number of School*
Email of school/suitable teacher (if available)*
Permission to contact your child's school to obtain information to support your application :*
- I agree
- I do not agree
ICHC is bound by the Privacy Policy of St Ignatius' College, Riverview.
I acknowledge and accept the privacy policy*
- Yes

Expression of Interest - Campers 2025

Child Details

Parent/Carer Information

Medical

Additional Information