PLUMBAGO STATION EXPEDITION

2016

February 20 - 27

STUDENT PREPARATION BOOKLET

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PLUMBAGO STATION EXPEDITION 2016 Student Preparation Booklet

Index Cover Index........................................................................................... 2 Welcome and Program Objectives............................................. 3 Program itinerary........................................................................ 4 Preparation checklist and timetable............................................ 5 Preparation notes (clothing, equipment, water)......................... 6 Preparation notes (food, example menu)................................... 7 Preparation notes (medication, hygiene, safety)........................ 8 Equipment checklist.................................................................... 9 Equipment checklist (cont.) ....................................................... 10 Preventative first aid ................................................................. 11 Clothing and equipment hire (with hire form attached)............. 13 Practice walk note…………………………………………………………………….15 Camp permission form (details)………………………………………………..17 Camp permission form……………………………………………………………..19 Medical form ………………………………………………………………………21/22

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WELCOME ! DATES - Saturday, February 20 - Saturday, February 27, 2016. LOCATION - Plumbago Station, via Broken Hill, NSW and Mannahill, South Australia ACTIVITY - Walking within a remote, arid environment Welcome to the final outdoor program experience during your time at Huntingtower - the Plumbago Station Expedition. Over the years, many of you have had an opportunity to look at, visit and explore a Marine Environment, a Forest Environment, an Alpine Environment and a Mountain Environment. Each of these programs has introduced new challenges, activities and environments with the aim of developing you as both an individual and as a caring member of a community. The program you are about to embark on in Year 11 provides the culmination of all these experiences. Set in an Arid Environment in the outback of South Australia, the Plumbago Station Expedition remains focused on one central theme – YOU ! This program has been designed to provide you with an opportunity to look at yourself as you move into the final stages of your secondary education - both as an individual, and how you contribute as a member of a community.

PROGRAM OBJECTIVES

To offer you a unique and challenging experience in a wilderness situation that is achievable by all students at Year 11.

To challenge you within this remote environment to accept real responsibility, provide leadership and develop a sense of community with all who are sharing this experience with you.

To introduce you to the beauty, remoteness and sometimes-harsh realities of the outback areas that exist in Australia, and in fact make up a vast majority of the continent.

To provide learning opportunities that encompass nature and man’s impact upon the environment, including conservation and sustainable rural farming.

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PROGRAM ITINERARY

Saturday February 20 - Meet at HT at 7.30am for an 8:00am departure We take coach transport from Huntingtower School to Hattah Lakes to camp for the night.

Sunday February 21 The coach transports us via Mildura to Broken Hill for lunch, before moving into South Australia along the Barrier Highway to the Mannahill turn off, and then on to Plumbago Homestead. There will then be a short preparatory walk to reach our first night’s campsite.

Monday February 22

Day 1 Walk

Tuesday February 23 Day 2 Walk

Wednesday February 24

Day 3 Walk and ‘Solo Experience’ (for groups 1 and 2) After a half-day walk, equipped with a groundsheet, some nibbles, a whistle and a few other items, you will be asked to move away from the group and locate a quiet, shady spot on your own for a few hours. The aim of this ‘solo experience’ is to sit alone in a remote wilderness environment and just think and reflect.

Thursday February 25

Day 4 Walk and ‘Solo Experience’ (for group 3)

Friday February 26

Day 5 Walk and Lake Cullulleraine - After a tearful farewell we head into Peterborough for a shower, swim and a meal at the local pool. Accommodation for the night will be at the Lake Cullulleraine Holiday Park some 65 km to the west of Mildura, with a bed, shower and real toilets.

Saturday February 27 After an early start to the day, our coach transport will return us to Huntingtower (roughly 4.00pm)

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PREPARATION CHECKLIST AND TIMETABLE

Done!

Action Item

Date to be done by or Meeting Date

Boots & socks purchased Before Christmas 2015

Student boots and socks - wear during school day All school days until February 20, 2016

Student training walk Monday February 1, 2016, 8:30 am

NOTE: this is before the start of Term 1

Student hire, permission and medical forms due Tuesday February 2

Parent Information Evening (PAC) Wednesday February 3, 6:30 – 7.45 pm

First Pack Check (Drama room) Thursday Feb 11, 4:00 pm onwards

Hire equipment distributed

FINAL equipment & food check (leave packs at school) Thursday Feb 18, 4:00 pm onwards

Depart Huntingtower (students arrive 7:30 am) Saturday Feb 20, 7.30 am

Dec

em

ber

Monday Tuesday Wednesday Thursday Friday Saturday Sunday

21 22 23 24 25 26 27

Have BOOTS by now!

Christmas Day

Feb

ruar

y

1 2 3 4 5 6 7 Practice Walk (8.30am @ HT)

Medical, Permission and Hire Forms Due

Parent Info Night – 6.30pm

8 9 10 11 12 13 14

FIRST Equipment Check (4pm onwards) -Drama Room

15 16 17 18 19 20 21

FINAL Equipment & Food Check (4pm on) – Drama Room All packs left at School Collect hire gear

Arrive at School by 7:30 am

23 24 25 26 27 28 1

Plumbago Expedition

Return to HT at 4:00pm (approx.)

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PREPARATION NOTES

BACK PACKS Students should be fully self-sufficient in all that they need, with each student being able to carry all his/her food, equipment and clothing in a backpack. This backpack must therefore be a good quality bag that will hold all they need and fit comfortably on their back. No extra bags are to be carried on, or items attached to, the outside of this pack. Please ensure that the pack used is large enough – around the 70 – 90 litre size. The compulsory waterbag will be the only external bag and this will be carried by hand. All packs should have padded, comfortable shoulder, chest and waist straps that are fully adjustable. No travel style packs are permitted.

CLOTHING The clothes you take to Plumbago should be practical and be able to withstand rough treatment. Remember you have to carry everything with you, so do yourself a favour and minimise the weight you will be carrying without compromising on appropriate clothes.

SLEEPING Everyone will be able to sleep quite comfortably in the open. The nights can be quite cool to cold, so you will need a sleeping mat, a ground sheet (large enough to put your sleeping bag on and then fold over you – minimum 3m x 3m), a few tent/sand pegs (aluminium is lighter) and a good quality sleeping bag with a hood. Insect repellent is essential. Roll-on repellent is the most effective (please avoid aerosol cans).

WATER Each participant will be provided with a 4-5 litre canvas water bag which they will need to look after and carry during the day. These will have been pre-soaked and prepared for use prior to departure from school. Each student will be allocated 10 litres of water per day and they will be responsible for its careful use. This water will cover their cooking, drinking and personal needs (not clothes or hair) in camp and their waterbag needs for a day’s walk.

Water = Life on Plumbago You must take care of our limited resources!

COOKING EQUIPMENT Open fires will not be used or allowed for cooking. Small fuel stoves, called Trangias, are provided. Fuel will also be provided. Eating utensils and a sharp knife for food preparation will be required along with a plate, bowl and mug.

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FOOD Food for ALL meals other than those marked ‘BUY’ in the table below, need to be purchased prior to Pack Check #2. You will be able to restock in Broken Hill on the Friday. There are no facilities to keep meat fresh.

Sat Sun Mon Tue Wed Thu Fri Sat Breakfast Home * * * * * * * or Buy Fri night Lunch Bring/Buy Buy * * * * * Buy Dinner * * * * * * * Home

You should think of your food as fuel. You will be walking all day with a heavy pack and your body will need as much energy as it can get. Make sure you plan healthy nutritious meals and snacks to keep you energetic for the walk. You need to plan for very nourishing breakfasts and evening meals, with light lunches that can be prepared quickly en-route. Great care must be given to the planning of your menu and food to ensure that you have sufficient nutritious food that is lightweight, easily packed and long lasting. Please bring a water bottle for use on the bus.

Do not bring salt tablets, cans of soft drink or caffeine-based drinks on this program.

Electrolyte replacing powders such as Gatorade or Powerade can be used in sensible amounts.

It is recommended that each student should provide at least $125 to cover the six (or seven) meals en route and $20 for general spending.

Example Menu

DAY BREAKFAST LUNCH DINNER SNACKS

Saturday (HOME) Bring from Home

or Purchase (Charlton)

Meat, Vegetables, Potatoes

Biscuits, Cake, Muesli Bars

Sunday Cereal, long-life or powdered milk, fruit

Purchase (Broken Hill)

Rice, Vegetables, Dried stew

Biscuits, Cake, Muesli Bars

Monday Cereal, long-life or powdered milk, fruit

Biscuits, cheese, fruit pack, salami, salad wraps.

Cup-a-Soup, Pasta, Vegetables,

Scroggin, Fruit, Muesli Bars

Tuesday

Cereal, long-life or powdered milk, fruit

Biscuits, cheese, muesli bars, fruit pack, salami, wrap with spread

Pasta/Rice, Dried stew

Scroggin, Fruit, Muesli Bars

Wednesday Cereal, long-life or powdered milk, fruit

Hot meal - Pasta, Vegetables

Solo - Cold meal as per a lunch

Scroggin, Fruit, Muesli Bars

Thursday Cereal, long-life or powdered milk, fruit

Biscuits, cheese, muesli bars, fruit pack, salami

Pasta/Rice, Dried stew

Scroggin, Fruit, Muesli Bars

Friday Cereal, long-life or powdered milk, fruit

Purchase (Peterborough)

Purchase (Renmark)

Purchase supplies for bus trip home

Saturday

Can be purchased on Friday (Renmark) Cereal, milk, bread, spreads, fruit, yoghurt

Purchase (Charlton)

(HOME) (HOME)

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MEDICATION All medication that you will, or might need, must be given to the Trip Leader prior to departure. This must be in a small named bag, together with written instructions as to the dosage and/or use. The Trip Leader will talk to your parents during the final pack check. Any other medical concerns should be discussed prior to the Plumbago expedition.

SHOWERS Showers will be available at the swimming pool in Peterborough on the Friday afternoon and at Lake Cullulleraine on Friday evening. Please ensure that you have appropriate swimwear to wear at the pool. Soap, shampoo and a towel will be needed for a shower prior to swimming.

GENERAL Students MUST NOT bring any radios, iPods, and electronic games.

Students MUST NOT bring any aerosols; use roll-on deodorant or insect repellent if required.

Bring only a normal table knife and a pocket knife – hunting knives are neither appropriate nor permitted.

Carry loose items in small bags (stuff bags).

Take extra foam padding or sheepskin for sore shoulders and hips.

Bring a small towel or strip of towelling to wet and put around your neck when walking.

Chocolate melts in high temperatures (M&M’s and Smarties last better).

Remember, we must carry out our rubbish so cut down on packaging (an old 2 litre milk bottle makes a great rubbish bin).

Liquids often leak in high temperatures unless stored in screw-topped containers.

ON-TRIP COSTS The only on-trip costs associated with this trip are in relation to food and additional equipment hire. It is suggested that $125 should cover all meals purchased en route. The equipment hire form is located at the back of this document.

TOILETS While out on the walk there will be no toilets. You will have to dig your own hole to dispose of the waste. In order to do that you will need to bring your own trowel and toilet paper. Most camping stores sell lightweight plastic trowels. NOTE: It is imperative for health reasons that you go to the toilet regularly. It is NO different to when you are at home. A ‘regular’ bowel system is a healthy one!

BASIC SAFETY RULES

No student is to leave the campsite or activity site without a leader’s

permission.

No student, by their actions, is to place themselves, any leader, other

student or group of students in a dangerous situation.

These two safety rules will be strictly enforced. If broken, the student involved will be

removed from the activity to safeguard the welfare of the remaining students.

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EQUIPMENT CHECKLIST Your pack should include all the following items for your participation in this program. The total weight of the pack should not exceed 17kg for boys and 14kg for girls.

***ALL EQUIPMENT AND CLOTHES NEED TO BE READY FOR THE FIRST PACK CHECK***

***EQUIPMENT, CLOTHES AND FOOD IS NEEDED FOR THE SECOND PACK CHECK***

Equipment / Clothing Check Comments Soap & container A small cake of travel soap or Wilderness Wash

Toilet paper, trowel (1 per food group) Minimum ½ roll, Max full roll. Plastic trowels are available from Disposals stores.

Toothbrush & paste Travel toothpaste or nearly finished standard one will reduce the weight you carry.

Towel x 1 A small towel is all that is necessary.

First aid items – Roller bandages x1, Rigid strapping tape, bandaids, safety pins, extra padding for sore spots, nail scissors (optional)

Crepe roller bandage x1 (minimum 6cm wide) Leukoplast (25mm) strapping/blister tape – red or blue container. Cut toenails before departing on trip.

Personal Protective Products - sunscreen, insect repellent, lip balm (SPF 15+, no paw paw)

Head Torch (plus spare batteries) Lightweight. One only

Notebook (small) / Pencil For solo experience, general note taking

*Backpack (no travel packs) Hire? 70-90 litre, padded straps. Can be hired from HT

*Sleeping bag & cotton/silk liner - Minimum comfort rating of 0oC

Hire? Liner keeps bag clean & if night is hot, it is cooler than the sleeping bag. Silk is lighter, cotton cheaper. Hired one is cotton.

Raincoat / Japara Hire? Japara or other lightweight waterproof jacket or cape. Can be hired.

*Sleeping mat x 1 Hire? 10mm closed cell foam sleeping mat.

Light weight tarpaulin, no smaller than 3m x 3m

3m x 3m provides enough room for sleeping bag to be setup on one half and the other half folded over in case of rain, or setup like a tent. DO NOT BUY A GROUNDSHEET

Pegs x 4 (min) – use aluminium or lightweight varieties

Aluminium pegs are lighter than steel pegs, and being often squarish in shape, are better in sand.

Rope (soft nylon or poly rope) 6-10 meters approx. 4 or 5 mm thickness

Use to make shelter with tarpaulin. Best if cut as needed.

Matches Waterproof in a small snap lock bag or similar

Plastic shopping bags x2 (minimum) For smelly clothes & rubbish etc.

Plastic garbage bags x2 1 to use in pack as a waterproof liner & the other to put gear in at end of trip when you hand back your pack before you depart for home.

Knife, fork, spoon As needed

Plate/bowl, mug Depending what you are eating, may get away with just a bowl or plate. AVOID METAL

Old 2L Milk bottle (for rubbish) One with a handle is easy to attach to the outside

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of your pack Equipment / Clothing Check Comments

Water bottle (1 – 1.5L) To carry spare water and for mixing Gatorade or other drinks when in camp.

Antibacterial hand gel (small bottle) Clean hands after toilet and before cooking or preparing meals.

Scourer, tea towel, detergent, jex or steel wool Ensure you have one additional steel wool for the final night wash up

Sunhat with broad brim MUST have a broad brim to keep the sun off your

head and neck. Caps or bucket hats are NOT acceptable. There must be a substantial brim. Sombreros are not advised.

Fly net – for face Fits over the top of your hat and keeps flies out, much more effective against flies than insect repellent and corked hats!

Sunglasses A cheap but UV effective pair will do. It is often very sunny.

Boots x1 Lace up style with high ankle support and stiff sole required. No elastic sided boots or shoe-style hiking footwear accepted.

Bathers x1 For swimming at Peterborough on the way home.

Beanie x1

Jumper – woollen / fleece / synthetic x1 It can get cool at night and early mornings. Cotton windcheaters are not recommended in case it rains, as they do not retain body heat when damp.

Shirt with long sleeves & collar for walking x2 Other shirts as needed

MUST have long sleeves on at least 2 shirts, to be worn always while walking. Others are for travel and when not walking!

Shorts for walking x2 Other shorts as needed

Should cover your thighs to help prevent sunburn. NO Running / Footy / Short Shorts!

Sneakers or Sandals (No thongs are to be used whilst hiking/camping)

In case of blisters while wearing boots, and for camp in the evening. Volleys are lightweight.

Walking Socks x5 (one for each walking day recommended) Other socks as needed

Thick wool blend are recommended for comfort and moisture wicking ability. Whatever you decide, make sure you are wearing them when you buy your boots to ensure a proper fit!

Tracksuit pants / long pants (optional) For when it is cool.

Underclothes x8 Other items as needed

Take only what you NEED for comfort and hygiene.

Thermals top and bottom x1

They are lightweight, small and can provide good warmth if required.

Menu - meal by meal Please have a written menu ready for the First Pack Check, showing what your cooking group is having for each meal. Make sure you have gone through the menu with your cooking group prior to the first pack check.

All foods - stored and labelled Use shopping bags to separate each day’s foods.

Snacks - stored Label and put in separate bags for each day’s supply.

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PREVENTATIVE FIRST AID SUNBURN - Prevention is better than the cure:

Wear suitable lightweight, loose and light coloured clothing at all times.

Wear a broad brimmed hat during all daylight hours.

Wear a shirt with long sleeves and a collar.

Wear shorts that cover most of your upper leg region.

During breaks, rest out of the sun.

Apply and reapply a 30+ SPF sun lotion to all exposed sections of your skin. If sunburnt, apply a cool, moist compress; never break blisters; inform a leader. BLISTERS - Prevention is the only answer on an extended walk:

Buy and wear proper fitting boots that are well worn in over some four weeks.

Toughen your feet by walking in the boots.

Socks - make sure there are no wrinkles and change them regularly.

Take time to clean your feet daily, then dry thoroughly.

If you blister easily, place bandaids, then Leukoplast tape over areas before the walk.

Upon noticing even the slightest ‘hot spot’, stop and apply bandaid, then Leukoplast tape. If blisters develop, inform a leader; never break a blister; consider sneakers. HYGIENE - Your internal and external hygiene is your responsibility: Internal hygiene -

Drink a steady amount of water on a regular basis. The body can only absorb 250ml (about a cup full) every 15 minutes, so gulping water is not effective.

Eat a variety of foods and take the time to prepare and cook them properly.

Gain enough fibre/roughage through cereals etc.

If possible eat some fresh fruit or fresh vegetables daily.

Clean all dishes and cutlery thoroughly and store in a clean bag.

Make sure you toilet daily and on a regular basis.

Report any internal troubles as early as possible to a friend or leader. External hygiene -

Skin - clean armpits and crotch regions regularly and dry carefully.

Hands - wash thoroughly before handling food and after toileting.

Feet - pay special attention to cuts, ‘hot spots’; change socks; clean daily.

Head - clean ears, teeth and neck on a daily basis.

Clothes - change underwear and external clothing as regularly as possible. Have a spare plastic bag so you can separate your dirty laundry.

Baby wipes are not ideal as they must be carried in your garbage container. MEDICATION - Beware of the dangers involved in taking any form of internal pills and/or medication in this hot environment given the nature of this walk.

If you plan to take any medication during this trip, you must notify Mr. PARSONS in writing.

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CLOTHING & EQUIPMENT HIRE On each of the Huntingtower Outdoor Education programs, there are some specialist items of clothing and equipment that normally fall outside the scope of most families and their circle of friends. Some items that every student will use have already been built into the cost of the trip. We have endeavoured to make the following items available to you at reasonable prices from an external provider. Pricing is as follows: (Please be aware that slight changes in price might occur from year to year.)

Backpack 75L, fully adjustable @ $35 for the trip

Sleeping mat @ $10 for the trip

Sleeping bag and liner @ $25 for the trip, and

Jacket, waterproof/breathable @ $25 for the trip

Canvas water bags are provided and built into the cost

Cuff Covers are provided and built into the cost

Trangia stoves and fuel are provided and built into the cost

Whistles are provided and built into the cost HIRE PROCEDURE 1. Complete the form below by marking the appropriate boxes 2. Return the completed form to the Year Level Coordinator, Mr Parsons, by Tuesday 2nd February 4. HIRED ITEMS DISTRIBUTED AT THE FINAL PACK CHECK 5. Even if you are not hiring any equipment, could you please return the form indicating your

intentions. All Prices quoted on this hire form include GST. ---------------------------------------------------------------------------------------------------------------------

HIRE FORM - Plumbago Station Expedition

Name:

Item / $ Total

Backpack 75L $35.00

Sleeping mat $10.00

Sleeping bag and Inner Sheet $25.00

Jacket, waterproof & breathable $25.00

TOTAL

Signed:

Date:

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HUNTINGTOWER SCHOOL SCHOOL EXCURSION FORM

Excursion: Plumbago Expedition Practice Walk Date: Monday February 1, 2016

Arrival Time: 8:30am

Finishing Time: Approximately 2:30pm

Clothing: Suitable for walking and the current weather (a long sleeve top is preferred,

no singlets). A sunhat (your wide brim hat for the trip would be good).You

must pack a rain jacket or japara in case of poor weather.

You must wear your Plumbago hiking boots.

Lunch: Students must provide a packed lunch to be carried in a backpack with

sufficient water for the day

While outside students should wear a cap and sunscreen to ensure adequate sun protection Emergency contact: School: 9807 8888

Yours Sincerely,

Leigh Parsons Nicholas Green Year 11 Coordinator Camps Coordinator --------------------------------------------------------------------------------------------------------------------------

Please detach and return to Mr. Parsons

PARENT CONSENT FORM I give permission for my son/daughter . to attend the excursion as set on the attached sheet. In an emergency I authorize the teacher in charge of the excursion to consent where it is impractical to communicate with me to the child receiving such Christian Science treatment or medical treatments, as it may be deemed necessary, in line with your request on your student’s Medical form. Signature of Parent/Guardian . Contact Name: Contact Number: . Emergency Contact Name: Contact Number: .

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Huntingtower School Camp Dear Parents/Guardians, Excursion to: Plumbago Station

Activity: Bushwalking

Date: 20 to 27 February, 2016

Accommodation: Camping

Departure Time: Arrive at 7.30am for an 8.00am 20 February

Return Time: Approx. 4.00pm, 27 February

Clothing: See Student Preparation Booklet

Meal Arrangements: Self-catered: See Student Preparation Booklet

Cost: All costs for this expedition are included in the student fees. Please refer to

the Student Preparation Booklet for additional costs of hire gear, food or

cash required for meals.

Special Requirements: It is highly recommended that all students have ambulance cover due to

the activity and location.

Emergency contacts: Huntingtower School: 9807 8888

Mr Noel Davies: 0423 600 504

While outside students should wear sunscreen and protective clothing to ensure adequate sun protection.

All forms should be returned to Mr. Parsons by Tuesday February 2, 2016

Students cannot board the bus without completed medical and consent forms.

Yours Sincerely,

Nicholas Green Camps Co-ordinator

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PERMISSION FORM

Plumbago Expedition – February 20 -27, 2016 I give permission for my son/daughter .

to attend the Year 11 Plumbago Expedition, as set on the attached sheet.

In the event of illness or injury to my child whilst at school, on an excursion, or travelling to or from school; I authorise the Principal or teacher in charge of my child, where the Principal or teacher in charge is unable to contact me, or if it is otherwise impracticable to contact me to:

Administer such first aid as the Principal or staff member may judge to be reasonably necessary

Consent to my child receiving such medical or surgical attention as may be deemed necessary by a medical practitioner.

Consent to and understand that I will be responsible for any costs incurred if an ambulance needs to be called.

Due to organisational requirements, I understand that if this form and payment (if required) are not returned by the due date my child will not be able to attend the above activity. Parents/Guardians are welcome to contact the class teacher and make other arrangements if unable to have the forms/money returned by the due date.

Parent/guardian: ______________________________________ (full name)

______________________________________ (signature) _________ (date)

In case of emergency I can be contacted on:

____________________________ OR: ____________________________

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STUDENT DETAILS

Surname: Given Name(s): _________________

Date of Birth: Mentor Group: _____

EMERGENCY CONTACT DETAILS

Parent/Guardian’s Name:

Address:

Telephone: (BH) (AH) (MOB)

MEDICAL INFORMATION

Doctor/Practitioner: Telephone:

Medicare Number: Expiry Date:

Private Health Cover: Y / N Fund Provider:

Contribution Number: Ambulance Cover: Y / N

Tetanus Immunisation Date:________________

MEDICAL CONDITIONS

Does your child suffer any allergies? Y / N Please specify: _____

What reaction do they have?__________________________ Is an Epipen required?: Y / N

Please circle if your child suffers any of the following:

Anxiety Asthma* Bed Wetting Back

Problems

Diabetes Dizzy Spells

Fits/Seizures Heart Condition Joint Problems Migraine Respiratory Issues Sleep Walking

Travel Sickness Other:_____________________________________________

Current medication(s): Dosage:

Are there further details or information that we require?

HUNTINGTOWER SCHOOL

CONFIDENTIAL MEDICAL REPORT FOR SCHOOL

CAMPS PLEASE ENSURE BOTH SIDES OF THE FORM ARE COMPLETED THOROUGHLY

IF A SECTION IS NOT APPLICABLE TO YOUR CHILD, PLEASE INDICATE

CLEARLY.

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DO YOU GIVE PERMISION FOR YOUR CHILD TO BE ADMINISTERED:

Paracetemol: Y / N Anti-Histamine: Y / N Ibuprofen: Y / N

DIETARY REQUIREMENTS

Vegetarian: Y / N Vegan: Y / N Religious Requirements: Y / N

Details:

SWIMMING ABILTY (please circle)

Non-swimmer Less than 50m 50-150m 150-300m More than 300m

CONSENT TO MEDICAL ATTENTION

In the event of a minor illness or accident, we prefer that treatment be sought from:

A CHRISTIAN SCIENCE PRACTITIONER ( ) A MEDICAL DOCTOR ( )

I authorise you or your staff in the event of illness or accident during this activity to obtain any

necessary medical assistance, transportation or hospital accommodation and I agree to pay all

fees and expenses incurred.

I authorise the teacher in charge to consent where it is impractical to communicate with me, to

the child receiving such medical or surgical treatment as may be deemed necessary.

I authorise any qualified medical practitioner to administer an anaesthetic or any other medical

or surgical treatment as may be deemed necessary.

Signature:_____________________________________ Date:_________________

Print name:____________________________________

PLEASE ENSURE BOTH SIDES OF THE FORM ARE COMPLETED THOROUGHLY

IF A SECTION IS NOT APPLICABLE TO YOUR CHILD, PLEASE INDICATE

CLEARLY