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CAMP GOODENOUGH YEAR 5 - 2011 Tuesday ... - St Hildas School

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<strong>CAMP</strong> <strong>GOODENOUGH</strong><br />

<strong>YEAR</strong> 5 - <strong>2011</strong><br />

<strong>Tuesday</strong> 14 – Thursday 16 June


Location<br />

„Camp Goodenough‟ is an Outdoor Adventure and Education Centre located at Bilambil in the Tweed<br />

Valley. Situated in part of the Mt Warning Caldera, the property is hilly with a mixture of naturally<br />

regenerating rainforest and magnificent views. „Camp Goodenough‟ is located 15mins from Tweed<br />

Heads. The address of the campsite is 253 Carool Rd, Bilambil, NSW. Phone: 5590 9614<br />

Aims<br />

The Year 5 camp aims to:<br />

Inspire self-confidence and a positive attitude.<br />

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Improve communication.<br />

Build Self-esteem.<br />

Improve leadership skills.<br />

Provide insight on how to be a more effective team member.<br />

<strong>St</strong>rengthen trust and co-operation.<br />

Develop respect for individuals‟ differences.<br />

Provide the students with an opportunity to experience Outdoor Education.<br />

<br />

Help students and staff to get to know each other and to develop a sense of belonging and<br />

community.<br />

Mrs Vail will be the teacher in charge of the camp accompanied by the Year 5 Form Teachers, Mrs<br />

Grimmer, Ms Power, House staff and other <strong>St</strong> Hilda‟s staff.<br />

A leadership program has been organised where everyone participates as an individual and as a<br />

member of a group. <strong>St</strong>aff, employed by Camp Goodenough, will be conducting the activities during the<br />

day. These activities, in which everyone will be involved, could include Abseiling, Flying Fox,<br />

Bushwalking, Environmental Awareness, Etriers, High Ropes, Indoor Climbing, Initiative Activities, Low<br />

Ropes.<br />

All girls are required to attend and participate in the camp, as it is part of this year‟s program. The cost of<br />

the camp is included in the school fees.<br />

There are strict guidelines, issued by the Health Department, regarding teachers administering<br />

medication to students. If your daughter is taking any medication or has any other medical problem,<br />

would you provide details of this on the attached medical information form. Preventative medicines for<br />

asthma and treatment of allergies must be sent to camp, even if your daughter has not suffered an<br />

attack recently. All medication, clearly labeled with the owner‟s name and instructions for administering<br />

should be placed in a clear plastic snap lock bag. Medication must be handed to Mrs Vail on arrival at<br />

camp. Should a problem arise just prior to the camp, written advice of this would be appreciated.<br />

In the <strong>School</strong> first aid kit there will be Panadol provided. This will only be issued to a student, suffering<br />

from a headache or other aches or pains, if permission has been given by one of her parents. <strong>St</strong>udents<br />

may bring their own pain relief medication but this, together with instructions for dispensing in a zip lock<br />

bag, must be handed to Mrs Vail. In the event of an accident or illness, every effort will be made to<br />

contact you.<br />

Please ensure that your daughter has a healthy morning tea and a drink preferably in a plastic bag for<br />

easy disposal for the first day.<br />

2


Please complete the medical information slip, asthma management form and the allergic reaction<br />

management form (if appropriate), and permission slip at the back of this information booklet and return<br />

these to <strong>School</strong> no later than Friday 27 May.<br />

Safety<br />

As with all programs conducted at <strong>St</strong> Hilda‟s school, Camp Goodenough operates with extremely high<br />

regard for student welfare. First aid equipment will be located at suitable locations. Bilambil is located<br />

close to several hospitals.<br />

We do ask that all families peruse carefully and complete the medical forms included at the end of this<br />

booklet. These need to be completed and returned to Form teachers by Friday 27 May.<br />

We also encourage parents to consider their health insurance arrangements. Residents of Queensland<br />

are covered for Ambulance Services by levy contribution through Energex. It is recommended that nonresidents<br />

of Queensland (including overseas students) should make arrangements for Ambulance<br />

Cover.<br />

<strong>St</strong>udents will be staying in cabins with bunk beds at the Camp Goodenough Outdoor Education facility,<br />

which has well-appointed amenities and a kitchen/dining area. The nature of the program and the<br />

intended outcomes at Camp Goodenough deliberately highlights increases in self-reliance and<br />

responsibility in the girls. Some activities may involve students using equipment not normally the<br />

province of classes at Southport. In these situations, there will be clear instructions and appropriate<br />

supervision.<br />

Travel Arrangements<br />

<strong>St</strong>udents will depart by bus from <strong>St</strong> Hilda‟s <strong>School</strong> (Cougal <strong>St</strong>reet) at 8.30am on <strong>Tuesday</strong> 14 June and<br />

return to the school at approximately 3.00pm on Thursday 16 June.<br />

We ask that all students arrive at school at 8.00am on the date of departure in order to allow enough<br />

time to pack the buses.<br />

3


What to Bring to Camp Goodenough<br />

□ WATERPROOF RAINCOAT WITH HOOD (ESSENTIAL) or Japara (some available for hire at school)<br />

□ SCHOOL SUN HAT AND SUNSCREEN (ESSENTIAL)<br />

□ SCHOOL SWIMMERS AND SUNSHIRT (ESSENTIAL)<br />

□ TEATOWEL (ESSENTIAL)<br />

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□<br />

□<br />

□<br />

□<br />

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□<br />

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□<br />

□<br />

□<br />

□<br />

□<br />

□<br />

□<br />

□<br />

□<br />

□<br />

□<br />

□<br />

□<br />

□<br />

□<br />

2 pair of long pants (eg. cargo pants, tracksuit pants – jeans are inappropriate as they are<br />

too restrictive)<br />

beanie<br />

gloves (woollen/polar fleece)<br />

1 tracksuit<br />

1 polar fleece or woollen jumper<br />

1 sweat shirt<br />

4 pair of shorts – MUST be knee length (for participation in ropes activities)<br />

4 T-shirts – must have sleeve and shirt length is long enough to be tucked into<br />

shorts/pants<br />

1 long sleeve T-shirt/shirt<br />

4-5 changes of underwear<br />

4 pair of socks<br />

PJ‟s or boxer shorts and T-shirt (no night shirts)<br />

2 pair of sneakers or sandshoes (1 old pair in case of rain)<br />

rubber thongs for use in showers<br />

bath towel and washer<br />

toilet requisites in a suitable bag (soap, toothpaste, toothbrush, deodorant – not in a spray can)<br />

Sanitary items as required<br />

brush or comb<br />

hair ties<br />

box of tissues<br />

sleeping bag<br />

fitted single sheet for mattress<br />

pillow and pillow case<br />

insect repellent (not in a spray can)<br />

2 plastic garbage bags (for wet and dirty clothes)<br />

1 small plastic bag (for personal rubbish)<br />

clipboard and school pencil case<br />

torch and spare batteries<br />

NAMED water bottle (enough to carry 1 litre of water)<br />

Small backpack with 2 shoulder straps to carry camp booklet, clipboard, pencil case,<br />

Raincoat,sunscreen and water bottle<br />

Please note: The campsite is set in a rainforest. It is NOT advisable to take newly purchased attire.<br />

Watches and cameras may be taken but are the responsibility of the owner.<br />

NO CD/CASSETTE PLAYERS, IPADS, IPODS/MP3’S, RADIOS, MOBILE PHONES, JEWELLERY<br />

(except watches), MAKE-UP, EXTRA FOOD OR PRESSURE CANS ARE TO BE TAKEN.<br />

ALL ITEMS TAKEN TO <strong>CAMP</strong> MUST BE CLEARLY NAMED<br />

4


Additional Information<br />

Sleeping Bag<br />

There are two types of sleeping bags to consider – both have advantages and disadvantages.<br />

Down<br />

Dacron<br />

Advantages Disadvantages Advantages Disadvantages<br />

Lightweight<br />

When wet, down Provides warmth even Bulkier bag<br />

collapses and hence<br />

less warmth<br />

when damp<br />

More warmth for less<br />

weight<br />

More expensive Less expensive Heavier bag<br />

There are many types of sleeping bags. A mummy bag ie: one that is tapered towards the feet provides<br />

more warmth than a square bag. The zip of the bag is very important and should be covered by a baffle<br />

(flap of sleeping bag) to keep the warmth inside the bag. A two-way zip allows the camper to undo the<br />

bag from either end. A bag that totally unzips will allow the camper to use it as a doona in warmer<br />

weather. The size of the teeth of the zip is important; small teeth are more likely to jam. The sleeping bag<br />

must have a hood to prevent heat escaping from the head (over 70% of body heat lost through head).<br />

****It is recommended that a ‘Mummy Bag’, with hood and the ability to compact to a small size<br />

be bought.<br />

Waterproof Coat<br />

o Must be waterproof (difference between showerproof – will withhold the rain for a short period of<br />

time, waterproof – will withhold rain for long period of time).<br />

o Must have a hood<br />

o Must cover student‟s bottom, preferable half way to knee in length.<br />

o Lightweight disposable ponchos are not suitable – they tear within 5 minutes.<br />

o Should have large teeth on zip – more durable.<br />

Hire Arrangements: There are a limited number of japaras (waterproof coats) available for hire<br />

through the school. <strong>St</strong>udents are required to book a japara through Mrs Wiebusch. Bookings can be<br />

made by email - kwiebusch@sthildas.qld.edu.au <strong>St</strong>udents will need to book early as, once all are<br />

assigned, students may miss out and will need to arrange their own. The school account will be<br />

charged the $20 hire fee.<br />

Polar Fleece<br />

o Polar Fleece is a much warmer fabric.<br />

o Polar Fleece will keep students warm when it is wet and body heat will dry it.<br />

o Cotton Windcheater appears warm and fluffy inside, but it is not as warm and will cause students<br />

to become colder when it is wet.<br />

5


Activity Descriptions<br />

The list covers some of the activities that your daughter may be involved in during her stay at Camp<br />

Goodenough.<br />

Each activity is lead by experienced professionals. The aim of this information is to keep you as fully<br />

informed as is reasonable and to alert you to some of the potential hazards.<br />

General<br />

People who live and learn in the Australian bush may encounter a variety of plants, animals and<br />

insects. Participants are instructed on how to deal with these to minimise the possibility of minor<br />

bites and stings.<br />

Participants are encouraged to be SunSmart, to drink plenty of water while on the program, to<br />

carry personal medications eg: Asthma puffers, and to wear enclosed shoes.<br />

During the course of most programs participants are asked to interact using a wide range of games<br />

and team building activities that may require running, jumping or other physical exercise.<br />

1. Travel<br />

Travel to and from the campsite will be by bus.<br />

The potential hazards for an individual include:<br />

<strong>St</strong>udents being injured during bus trip (collisions)<br />

Bus Sickness<br />

Dehydration<br />

Management of Activity<br />

Supervision of students during travel to ensure seat belts are worn and students are seated<br />

correctly.<br />

Female staff member to ensure safety of girls at food and toilet stops.<br />

The groups stays together at all times accompanied by staff members.<br />

<strong>St</strong>udent medical records checked prior to treatment and instructions followed.<br />

If the injury/illness is major an ambulance will be called and the student‟s parent will be<br />

contacted.<br />

Mobile phone contact between staff on different vehicles in case of emergency<br />

2. Accommodation<br />

This activity involves sleeping in cabins at Camp Goodenough with single size bunk beds.<br />

The potential hazards for an individual include:<br />

Environmental hazards eg: adverse climatic conditions<br />

Physical hazards eg: Falls from height<br />

Other potentially hazardous biological hazards include: insects etc<br />

Management of Activity<br />

Briefing of students about the nature and purpose of the cabins<br />

Briefing of students about the potential hazards and appropriate safety procedures.<br />

<strong>St</strong>udents informed of staff member who is allocated First Aid Officer.<br />

Provision of female staff members to supervise accommodation<br />

Allocation of rooms to students<br />

8:45pm lock down of rooms<br />

Briefing on appropriate clothing and footwear.<br />

Briefing students on hygiene guidelines related to food, water and toileting.<br />

6


3. Bushwalking around campsite<br />

This activity involves carrying a day backpack containing: medication (if required), sunscreen,<br />

camp folder, pencil case and waterproof coat. <strong>St</strong>udents will walk on the various set bushwalking<br />

routes on the property.<br />

The potential hazards for an individual include:<br />

Participant not following safety guidelines<br />

Participants tripping over uneven ground<br />

Long bushwalks may be strenuous.<br />

Environmental factors may make walking uncomfortable or lead to injury or illness.<br />

Other potentially hazardous environmental features include cliffs, falling rocks/tree limbs, rivers,<br />

dams, barb wire fences and sharp or hazardous plants, animal/insect attack<br />

Management of Activity<br />

Briefing of students about the nature and purpose of the activity.<br />

Briefing of students about the potential hazards and appropriate safety procedures (<strong>St</strong>aff<br />

member near the front of group and at rear).<br />

<strong>St</strong>udents informed of staff member who is allocated First Aid Officer.<br />

Briefing of students on procedures if lost.<br />

Briefing on appropriate clothing, footwear and sun safety - clothing is checked for suitability for<br />

walk.<br />

<strong>St</strong>udents back packs checked for appropriate items and adequate water and food.<br />

4. High Ropes Course<br />

Ropes courses usually involve performing either a team or individual activity above the ground<br />

often with the aid of steel cables. Climbing, jumping walking or deliberately falling from a height are<br />

all possible. Height above the ground may vary from 30cm to 15 metres. Such activities require<br />

personal skill and/or team support for success. Activities are sequenced so that safety procedures<br />

are learnt, practiced and closely followed at all times.<br />

High Rope Course elements usually involve climbing a tree using tree staples, a ladder or other<br />

device to access a rope or cable up to 15 metres above the ground. Safety devices include a<br />

harness, belay (rope safety system) and a helmet where necessary. Potential hazards include fear<br />

of the perceived risk or of heights. Minor injury due to lack of participant concentration. Major injury<br />

if safety guidelines are not followed especially on high elements. <strong>St</strong>udents are alerted to these<br />

hazards.<br />

• Such courses have an excellent safety record in the outdoor education industry.<br />

The potential hazards for an individual include:<br />

Participant not following safety guidelines<br />

Equipment failure<br />

Collapse of tree supporting cables<br />

Participant detaching both safety tapes<br />

Participant panics along course<br />

Feet slip off cables – too wet/muddy<br />

Rope burn<br />

Management of Activity<br />

Briefing of students about the nature and purpose of the activity.<br />

Briefing on safety procedures and potential hazards, including falling debris, fear of heights and<br />

bumps and scratches.<br />

<strong>St</strong>udents informed of staff member who is allocated First Aid Officer.<br />

Inspect clothing and footwear.<br />

Inspect safety helmets, harnesses and safety tapes.<br />

<strong>St</strong>udents encouraged to take water bottles to each activity. Fruit and drink breaks are<br />

provided.<br />

<strong>St</strong>udents are encouraged to apply sunscreen at regular intervals during the day and<br />

appropriate clothing.<br />

Instructor aware of medical conditions of each participant.<br />

7


5. Indoor Rock Climbing and Abseiling<br />

Indoor Rock Climbing and Abseiling usually involves ascending and descending indoor cliffs. This<br />

activity is conducted in a built environment that utilizes specialized equipment and ropes. Height<br />

above the ground may vary from 30cm to 6 metres. Such activities require personal skill and/or<br />

team support for success. Activities are sequenced so that safety procedures are learnt, practised<br />

and closely followed at all times.<br />

Safety devices include a harness, belay (rope safety system) and a helmet. Potential hazards<br />

include fear of the perceived risk or of heights. Minor injury due to lack of participant concentration.<br />

Major injury if safety guidelines are not followed. <strong>St</strong>udents are alerted to these hazards.<br />

• Such courses have an excellent safety record in the outdoor education industry.<br />

The potential hazards for an individual include:<br />

<br />

<br />

<br />

<br />

<br />

<br />

<br />

Participant not following safety guidelines<br />

Equipment failure<br />

Falling to the floor<br />

Lack of student concentration, panic<br />

Participant losing handhold on rope<br />

Ropes not properly secured<br />

Participant losing footing on surface<br />

Management of Activity<br />

Briefing of students about the nature and purpose of the activity.<br />

Briefing on safety procedures and potential hazards, including falling debris, fear of heights and<br />

bumps and scratches.<br />

<strong>St</strong>udents informed of staff member who is allocated First Aid Officer.<br />

Inspect clothing and footwear.<br />

Inspect safety helmets and harnesses.<br />

<strong>St</strong>udents encouraged to take water bottles to each activity. Fruit and drink breaks are<br />

provided.<br />

<strong>St</strong>udents are encouraged to apply sunscreen at regular intervals during the day and<br />

appropriate clothing.<br />

Instructor aware of medical conditions of each participant.<br />

6. Night Walk<br />

This activity involves students walking through a specific area surrounding the campsite,<br />

stargazing and listening to the sounds of the bush.<br />

The potential hazards for an individual include:<br />

Becoming injured while away from camp area.<br />

Environmental factors may make walking uncomfortable or lead to injury or illness.<br />

Other potentially hazardous environmental features include, steep slopes, falling rocks/tree<br />

limbs, uneven ground and sharp plants, leeches, ticks and snakes.<br />

Management of Activity<br />

Briefing of students about the nature and purpose of the activity.<br />

Briefing of students about the potential hazards and appropriate safety procedures (<strong>St</strong>aff<br />

member near the front and rear of the group).<br />

<strong>St</strong>udents informed of staff member who is allocated First Aid officer.<br />

Briefing of students on procedures if lost.<br />

Briefing on appropriate clothing and footwear.<br />

<strong>St</strong>aff members carrying First Aid Kit and torches.<br />

Briefing of students on night vision.<br />

Briefing of students on formation and communication required walking through the bush at<br />

night.<br />

8


7. Etriers<br />

Etrier is the name given to the short ladders used for this activity, hence the name “Etriers”. The<br />

technique is used in conjunction with rock climbing and is used by climbers when passing under<br />

an overhang or ceiling of rock. Removing the need to hang on by wedging their fingers and feet<br />

into<br />

cracks and crevices, the etrier ladders are anchored in position and the climber then supports their<br />

weight on the first ladder whilst a second ladder is being attached. By transferring their body weight<br />

from one ladder to the next and moving the ladders consecutively, climbers are able to traverse a<br />

difficult area with relative ease.<br />

This activity is conducted in a built environment that utilizes specialized equipment and ropes.<br />

Height above the ground may vary from 30cm to 15 metres. Such activities require personal skill<br />

and/or team support for success. Activities are sequenced so that safety procedures are learnt,<br />

practiced and closely followed at all times.<br />

Safety devices include a Helmet, Harness, Carabiners, Etrier Ladders and Safety Tapes.<br />

Potential hazards include fear of the perceived risk or of heights. Minor injury due to lack of<br />

participant concentration. Major injury if safety guidelines are not followed. <strong>St</strong>udents are alerted to<br />

these hazards.<br />

• Such courses have an excellent safety record in the outdoor education industry.<br />

The potential hazards for an individual include:<br />

<br />

<br />

<br />

<br />

<br />

<br />

<br />

<br />

<br />

<br />

Participant not following safety guidelines<br />

Participants tripping over uneven ground<br />

Participant not understanding what to do<br />

Equipment failure<br />

Harness not properly secured to the participant<br />

Participant detaches both safety tapes<br />

Belay rope not attached before ladder descent<br />

Lack of student concentration, panic<br />

Wet equipment<br />

Muddy ground<br />

Management of Activity<br />

Briefing of students about the nature and purpose of the activity.<br />

Briefing on safety procedures and potential hazards, including falling debris, fear of heights and<br />

bumps and scratches.<br />

<strong>St</strong>udents informed of staff member who is allocated First Aid Officer.<br />

Inspect clothing and footwear.<br />

Inspect safety helmets and harnesses.<br />

<strong>St</strong>udents encouraged to take water bottles to each activity. Fruit and drink breaks are<br />

provided.<br />

<strong>St</strong>udents are encouraged to apply sunscreen at regular intervals during the day and<br />

appropriate clothing.<br />

Instructor aware of medical conditions of each participant.<br />

8. Flying Fox<br />

Flying Fox usually involves launching from an Abseil platform. This activity is conducted in a built<br />

environment that utilizes specialized equipment and ropes. Height above the ground may vary from<br />

6m to 10 metres. Activities are sequenced so that safety procedures are learnt, practiced and<br />

closely followed at all times.<br />

Safety devices include a Helmet, Full Body Harness, Flying Fox Pulley and safety tapes. Potential<br />

hazards include fear of the perceived risk or of heights. Minor injury due to lack of participant<br />

concentration. Major injury if safety guidelines are not followed. <strong>St</strong>udents are alerted to these<br />

hazards.<br />

9


• Such courses have an excellent safety record in the outdoor education industry.<br />

The potential hazards for an individual include:<br />

Participant not following safety guidelines<br />

Participants tripping over uneven ground<br />

Participant not understanding what to do<br />

Equipment failure<br />

Harness not properly secured to the participant<br />

Participant detaches both safety tapes<br />

Lack of student concentration, panic<br />

Management of Activity<br />

Briefing of students about the nature and purpose of the activity.<br />

Briefing on safety procedures and potential hazards, including falling debris, fear of heightsand<br />

bumps and scratches.<br />

<strong>St</strong>udents informed of staff member who is allocated First Aid Officer.<br />

Inspect clothing and footwear.<br />

Inspect safety helmets and harnesses.<br />

<strong>St</strong>udents encouraged to take water bottles to each activity. Fruit and drink breaks are<br />

provided.<br />

<strong>St</strong>udents are encouraged to apply sunscreen at regular intervals during the day and<br />

appropriate clothing.<br />

Instructor aware of medical conditions of each participant.<br />

9. Swimming in Pool during Free time activity<br />

This activity involves swimming in a pool as a free time activity.<br />

The potential hazards for an individual include:<br />

Drowning<br />

Cuts from surface surrounding pool<br />

Hypothermia<br />

Dehydration<br />

Sunburn<br />

Management of Activity<br />

A prerequisite of this activity is that students need to be able to swim unaided for 25m.<br />

Briefing of students about the nature and purpose of the activity.<br />

Briefing of students about the potential hazards and appropriate safety procedures.<br />

Equipment checked before commencement of activity.<br />

Weather check before and during session.<br />

Participants are made aware of emergency signals.<br />

Areas checked and participants informed of potential hazards.<br />

Boundaries set for shallow and deep water<br />

Participants to stay between instructors and teachers.<br />

<strong>St</strong>udents informed of staff member who is allocated First Aid Officer.<br />

<strong>St</strong>udents encouraged to take water bottles to each activity. Fruit and drink breaks are<br />

provided.<br />

<strong>St</strong>udents are encouraged to apply sunscreen at regular intervals during the day and an<br />

appropriate clothing check including swimmers and sunshirt is conducted before each activity.<br />

Instructor aware of medical conditions and swimming ability of each participant.<br />

10


10. Group Initiatives – Nightime activities and games and movement<br />

around the campsite for meals<br />

These activities involve challenging tasks that use group problem solving, teamwork and cooperation.<br />

These tasks are generally non-competitive and are perfect for groups to get to know<br />

each other.<br />

The potential hazards for an individual include:<br />

<strong>St</strong>udents being injured during activity (falls, collisions)<br />

Dehydration<br />

Management of Activity<br />

Briefing of students about the nature and purpose of the activity.<br />

Briefing of students about the potential hazards and appropriate safety procedures.<br />

<strong>St</strong>udents always in groups of four<br />

All students will be instructed on correct safety procedures<br />

A central meeting point with specified check in times will be prearranged<br />

Where applicable younger students will always be accompanied by a member of staff<br />

<strong>St</strong>udents are encouraged to take water bottles to each activity. Breaks are provided.<br />

<strong>St</strong>udents encouraged to take water bottles to each activity. Fruit and drink breaks are<br />

provided.<br />

<strong>St</strong>udents are encouraged to apply sunscreen at regular intervals during the day and<br />

appropriate clothing.<br />

Instructor aware of medical conditions of each participant.<br />

For more information on any of the above, please contact Mrs K Wiebusch (5577 7230).<br />

11


Please complete and return<br />

the following forms<br />

to Junior <strong>School</strong> Reception<br />

by:<br />

Friday 27 May <strong>2011</strong><br />

12


To: Mrs Cleverly<br />

I hereby give permission for my daughter –<br />

NAME<br />

ADDRESS<br />

________________________________________<br />

________________________________________<br />

________________________________________<br />

________________________________________<br />

HOME TELEPHONE<br />

MOBILE TELEPHONE<br />

________________________________________ (for emergencies)<br />

________________________________________<br />

I have read the risk management procedures and have been fully informed of the procedures in place. I<br />

give permission for my daughter to attend the Year 5 Camp from <strong>Tuesday</strong> 14 June to Thursday 16<br />

June and undertake all activities.<br />

I agree to meet the expenses of my daughter being returned to school either by a teacher accompanying<br />

her and then returning to camp, or by collecting my daughter from the camp personally. I understand<br />

that such an arrangement may be necessary due to illness, injury, or if, in the opinion of the teacher in<br />

charge, there is non co-operation of any description by my daughter.<br />

In the event of accident or illness, I authorise the teacher in charge of the camp to consent to my<br />

daughter receiving such medical treatment deemed necessary, when all reasonable attempts to<br />

communicate with me have been unsuccessful.<br />

Parent/Guardian Signature: _______________________________<br />

Date: _______________<br />

PLEASE RETURN THESE FORMS<br />

TO THE JUNIOR SCHOOL RECEPTION BY: FRIDAY 27 MAY <strong>2011</strong><br />

13


MEDICATION FORM<br />

In the event of my daughter developing a headache or other aches or pains, I give permission for a <strong>St</strong><br />

Hilda‟s staff member to issue as directed:-<br />

(Please tick)<br />

□ Tablet Panadol<br />

□ Liquid Panadol<br />

□ Liquid Nurofen<br />

□ Tablet Nurofen<br />

□ Clarityne<br />

□ Dimetapp Elixir<br />

□ Other (please supply and specify)…………………………………………….<br />

<strong>St</strong>udent Name: _____________________________________<br />

Parent/Guardian Signature: ____________________________<br />

Date: _____________<br />

• All medication must be clearly labelled with the student’s name and the<br />

required dosage<br />

• All medication must be given to Mrs Vail on arrival at camp in a zip lock<br />

bag<br />

14


ST HILDA’S JUNIOR SCHOOL<br />

STUDENT MEDICAL RECORD<br />

GENERAL INFORMATION<br />

NAME:…………………………………………………………………………………………..…………………………<br />

FORM CLASS:………………………………….<br />

ADDRESS:………………………………………………………………………………………………………………...<br />

……………………………………………………………………………………………………...................................<br />

DATE OF BIRTH:………………………...…….<br />

CONTACT PERSON / PHONES:<br />

DAY<br />

NIGHT<br />

NAME OF CONTACT<br />

PERSON<br />

RELATIONSHIP<br />

CONTACT PHONE<br />

FAMILY DOCTOR:<br />

NAME: ………………………………………………………………………………………………………………..<br />

ADDRESS:………………………………………………………………………………………………………………<br />

……………………………………………………………………………………………………………………………<br />

PHONE…………………………………………………………………………<br />

MEDICARE NUMBER: ……………………………………………………<br />

NO. ON CARD ………………..<br />

PRIVATE HEALTH CARE FUND: …………………………………………………………………….……………..<br />

MEMBERSHIP NUMBER: ………………………………………………………………………………………………<br />

MEDICATION INFORMATION<br />

Is your daughter currently taking any medication?<br />

YES / NO<br />

If YES, please give details:<br />

MEDICATION<br />

REASON FOR TAKING<br />

MEDICATION<br />

WHEN MEDICATION IS TO BE<br />

ADMINISTERED<br />

If there are any changes to the above prior to the departure for the camp, please contact<br />

Mrs Vail – Teacher-in-Charge.<br />

15


MEDICAL HISTORY<br />

When did your daughter last have a Tetanus booster?<br />

……………………………………………………………………………………………………………………………...<br />

DOES YOUR DAUGHTER SUFFER FROM ANY OF THE FOLLOWING CONDITIONS?<br />

CONDITION YES / NO MANAGEMENT PLAN<br />

Allergies (plants / animals)<br />

Asthma<br />

PLEASE COMPLETE THE ATTACHED INFORMATION<br />

SHEET<br />

Blackouts<br />

Diabetes<br />

Disability of any kind<br />

Dizzy spells<br />

Epilepsy<br />

Fits of any kind<br />

Heart condition<br />

Migraine<br />

Recent / Recurrent illness<br />

Sleepwalking<br />

Travel sickness<br />

Others (Please specify)<br />

SPECIAL DIETARY REQUIREMENTS<br />

Is your daughter allergic to any foods?<br />

YES / NO<br />

If YES, please give details:<br />

……………………………………………………………………………………………………………………………..<br />

Is your daughter vegetarian?<br />

YES / NO<br />

If YES, please give details:<br />

……………………………………………………………………………………………………………………………..<br />

Any other information relating to diet:<br />

……………………………………………………………………………………………………………………………..<br />

……………………………………………………………………………………………………………………………..<br />

16


ASTHMA MANAGEMENT INFORMATION<br />

NAME OF STUDENT:<br />

__________________________________________________________________________________<br />

ONLY COMPLETE IF YOUR DAUGHTER HAS A HISTORY OF ASTHMA<br />

This information is of vital importance in the event of an asthma attack as it will assist in the speedy<br />

provision of correct treatment.<br />

Is preventative medication used<br />

regularly?<br />

Has a maintenance program been<br />

worked out with your family doctor in<br />

order to reduce the<br />

frequency/severity of attacks?<br />

Is your daughter on any reliever<br />

medications?<br />

What is the medication and<br />

treatment to be used during an<br />

attack?<br />

Does your daughter always carry<br />

her medication with her?<br />

YES / NO<br />

DETAILS / INFORMATION<br />

If yes, which medication/s?<br />

If yes, what is the normal maintenance program<br />

followed by your daughter?<br />

If yes, please outline medication/s<br />

Does your daughter own / use a<br />

Peak Flow Metre?<br />

If yes, what would indicate that medication and /or<br />

medical attention is required?<br />

List any known asthmatic trigger<br />

factor/s experienced by your<br />

daughter.<br />

Has your daughter been admitted to<br />

hospital due to asthma attacks in the<br />

last 12 months?<br />

Does your daughter suffer sudden<br />

asthma attacks requiring<br />

hospitalisation?<br />

If yes, give details.<br />

If yes, give details.<br />

Parent‟s Signature: ___________________________________________________________________<br />

Date: _______________________________<br />

17

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