HAERE MAI, TEEN CAMPERS

Campers Application | Takapuna Summer Camp 2026

"*" indicates required fields

KIA ORA! Please complete the form below to apply as a camper for Takapuna Summer Camp 2026

Personal Information

Name*

First Name Surname

Date of birth*

DD slash MM slash YYYY

Email Address*

Mobile*

Are you*

Male

Female

Home Address*

Street Address Suburb City Postcode

In 2026, which Year Group will you be a part of?*

Year 9

Year 10

Year 11

Year 12

Year 13

Please note, this camp is for teens between Years 9-13. If you are currently in Year 8 and wish to attend camp, you need to contact us.

In 2026, which school will you be attending?*

What parish community are you a part of?*

What is your T-shirt size?*

T-shirts are in NZ men's sizes

Dietary Requirements

Do you have any dietary requirements?*

Yes

Please select from below:*

Vegetarian

Vegan

Gluten Free / Coeliac

Dairy free / Lactose intolerance

Nut allergy

Seafood allergy

Animals

Other

Please explain your dietary requirements/allergies in detail if needed:*

If other, please indicate:*

General Health & Medical Information

We encourage you to fill the next few sections with your parents/caregivers. Several of our Core Team members are First Aid trained and can support basic health needs, but cannot manage severe or complex medical conditions. Teens are responsible for bringing their own emergency medication (e.g., EpiPen). If you would like camp staff to store/manage it, please indicate here so we can discuss arrangements with you. This information will be treated confidentially.

Does your teen have any medical conditions we should be aware of?*

Yes

(e.g., asthma, diabetes, epilepsy)

“If yes, please describe how this condition affects your teen’s daily life and if there are any specific steps the youth team should take to support them.”*

Does your teen have any allergies (food, environmental, medication)*

Yes

Please specify reaction and severity.*

Does your teen require an EpiPen or other emergency medication?*

Yes

If yes, please list each medication, its dosage, and the times it needs to be taken.*

Type “Not Applicable” if your teen does not take any medication. Campers are responsible for taking their own medication on time. If you would like staff to store or manage it, please indicate here so we can discuss arrangements with you.

Has your teen had any recent illness, injury, or surgery we should know about?*

Yes

If yes, are there any activity restrictions or special care instructions we should follow during camp?*

Mental Health Medication Information

This information will be treated confidentially.

Does your teen have any diagnosed/undiagnosed neurodivergent/mental health conditions?*

Yes

(e.g., ADHD, Autism Spectrum, Dyslexia, Dyspraxia, etc.) or mental health condition (e.g., anxiety, depression)?

What condition does your teen have?*

How does this condition affect your teen day-to-day?*

(e.g., energy, social interactions, focus, routines, sensory needs).

Are there any specific triggers or stressors we should be aware of?*

Please let us know if there are any situations, environments, or experiences that may cause your teen stress, anxiety, or discomfort at camp. This can include loud noises, crowded spaces, certain activities, changes in routine, or social interactions.

Does your teen take any medication for mental health or neurodivergent conditions?*

Yes

Name of medication(s):*

Dosage and timing*

Are there any specific instructions, side effects, or emergency protocols we should be aware of?*

Emergency Contact / Parent Contact

Name*

First Name Surname

What is your relationship with this person?*

Mobile*

Parent/Guardian Consent

Consent*

I understand and support St Joseph's Youth group zero-tolerance policy on bullying, and I agree to speak with my teen about treating others with kindness and respect.*

St Joseph's Youth is committed to providing a safe, inclusive, and respectful environment for all young people. Bullying of any kind—whether physical, verbal, emotional, or digital—is not tolerated. If your teen ever experiences or witnesses bullying, we encourage them to speak with a group leader or trusted adult. Any reports made will be handled confidentially and shared only with staff as needed to ensure your teen’s safety and well-being. Please know we take all concerns seriously and are here to support your teen.

Consent*

Rule Enforcement / Pickup:*

I understand that if my teen breaks camp rules, I may be required to pick them up early.

Consent*

Limited Phone Usage*

I consent to my teen having limited phone access during camp, in line with camp rules.

Consent*

I agree to be responsible for any damages caused by my teen during the retreat and understand that I may be asked to cover the cost of repairs or replacements*

This includes any costs related to repairs, replacements, medication or any other expenses incurred on their behalf. Parents will be billed after the event.

Consent*

I give permission for photos/videos of my child to be taken and used by St Joseph Youth for appropriate group-related purposes.*

During youth group activities and events, we may take photos or videos to capture meaningful moments. These may be used in newsletters, private group communications, or on St Joseph's website or social media. We are committed to using all media respectfully.

Consent*

I have read the privacy statement and wish to continue with my registration*

By completing this form, I consent to my information being stored and used for the pastoral and administrative purposes of the Core Team. I understand that my data will be held securely and that I have a right to access my information. I understand that when this information is no longer required for this purpose, my data will be disposed of according to the Public Records Act 2005 (PRA).

Conset*

My parent signing & dating below indicates that I have read and understand the above.*

Full Name*

Payment

We are grateful to the parish of St Joseph’s Takapuna and to our generous donors and fundraising supporters, whose contributions help subsidise Takapuna Summer Camp 2026. To cover remaining costs, the early bird registration fee is $250 per participant, available until Sunday, 14th December. From Monday, 15th December, the fee will be $260. A non-refundable deposit of $50 is required to the Core Team to confirm your spot.

I have a PROMO CODE*

Yes, I have a promo code

No, I do not have a promo code

Camp Fees*

Deposit (pay balance later)

Full Registration

Total

Teen Campers

HAERE MAI, TEEN CAMPERS

Campers Application | Takapuna Summer Camp 2026

Personal Information

Dietary Requirements

General Health & Medical Information

Mental Health Medication Information

Emergency Contact / Parent Contact

Parent/Guardian Consent

Payment

St Joseph's Church