$20 per day inc. GST OR $55 for the 3 Days

At Riverbend we want to care for each child who comes to our holiday camps. This begins when the child is dropped off and continues until they are picked up by their legal parents/guardians. To help us please fill in any required details. Please note that all information is treated confidentially.  Leaders and support staff are briefed on medical/behavioural problems that may require special care.

Parent / Guardian Consent & Authority

Riverbend is a Christian campsite administered by the Christian Brethren Churches of Circular Head.
We expect all campers to FULLY participate in all camp activities including games, Bible studies and devotions.

I, the undersigned, agree to the camper/s  named in this application attending Riverbend Youth Centre for the period noted and agree to them participating in the activities provided by Riverbend Youth centre.  These may include messy games, indoor games, outdoor games, Flying Fox, Flying Squirrel, Waterslide, pool visit, excursions, Jumping Pillow, Indoor Bungee Run, Indoor Jumping castle and push bikes.  All campers are required to observe all necessary safety rules given by Riverbend staff and leaders.  I appreciate that there are risks involved in these activities.  I understand that whilst every care will be taken, Riverbend staff and leaders cannot and do not guarantee that campers will not sustain personal injury or loss or theft of property during their camp.  I release Riverbend Youth centre from all claims arising out of personal injury, or loss or theft of property sustained by the camper/s named in this application during their camp except only to the extent that said personal injury or loss of theft of property is occasioned due to negligence on the part of Riverbend, its staff or its leaders.  

I agree to advise Riverbend Youth centre if, prior to the camp commencing, the applicants/s contract any ailments considered  to be detrimental to the health of other campers.

I authorise Riverbend staff to obtain for the applicant/s all medical treatment and attention considered reasonably necessary at my expense, provided I am notified of the circumstances and treatment required as soon as practicable.

I understand that if the camper does not abide by Riverbend’s code of conduct, camp management reserves the right to contact me and have them sent home from the camp.


Male, Female

Days Attending

All Days, Day 1 (20th April) Only, Day 2 (21st April) Only, Day 3 (22nd April) Only, Day 1& 2, Day 2 & 3, Day 1 & 3

Event Details

Day 1: April 06, 2021

Day 2: April 07, 2021

Day 3: April 08, 2021

Start time: 09:00 a.m.

End time: 16:00 p.m.

Venue: Riverbend Youth Centre

Phone: 0364521635