Kilbroney Weekend Blast 2016

My child agrees to abide within all the rules and regulations set down by Down and Dromore to ensure the safe and enjoyable running of camp. I understand that Down and Dromore are not liable in respect of any personal injury, loss or damage to personal property, unless the personal injury, loss or damage is the result of negligence on the part of Down and Dromore.

Yes No

Signed: (parent/ guardian) ________________________________________ Print name ____________________________________________________ Address ______________________________________________________ ______________________________________________________________ E-mail ________________________________________________________ Home Tel ____________________ Mobile _______________________ In the event you cannot be contacted please provide the contact mobile number of a second person with responsibility for your child: Name ______________________ Telephone ____________________ Please indicate who will be leaving the camper to Kilbroney and who will be collecting them: Leaving _____________________ Collecting ____________________

KILBRONEY WEEKEND BLAST

MEDICAL & DIETARY INFO Please supply any medical information about your child that we should be aware of (allergies, asthma, diabetes, epilepsy etc): ________________________________________________________ If your child will be taking any medication or treatment over the duration of the camp please ensure that they bring their medication and supply details on instructions for it below: _______________________________________________________________ _______________________________________________________________ _______________________________________________________________ DOCTORS DETAILS: Name _________________________ Telephone ______________________ Address ________________________________________________________ Child’s medical number ____________________________________________ Please note that during the weekend you can contact us through Diocesan Youth Officer, Tim Burns, on 07572817429. On receipt of your application we will write back to you with a further information pack including the programme and kit list.

Closing date for applications is Friday 14th October, but places may fill up quickly so they will be allocated on a first come basis on receipt of deposit. Please return to Tim Burns, Church of Ireland House, 61-67 Donegall Street, Belfast, BT1 2QH

FRIDAY 4TH - SATURDAY 6TH NOVEMBER 2016 Kilbroney Centre, Rostrevor For those in 4th,5th & L.6th Year

WHAT IS IT? A fun filled weekend away meeting old friends, making new ones, learning about God and having a laugh. The weekend is open to anyone in 4th, 5th or lower 6th, come with a group from church or come by yourself as no leader is needed to come with you, we will have plenty of friendly leaders there.

WHAT ARE WE DOING?

APPLICATION FORM CAMPER NAME _______________________________________ AGE ____________________ D.O.B _______________________ ADDRESS ____________________________________________ _____________________________________________________ MALE/FEMALE ______________ SCHOOL YEAR __________ CHURCH _____________________________________________ ROOM REQUESTS _________________ __________________ _________________ __________________ £15 DEPOSIT ENCLOSED? (Non refundable) (Cheques payable to ‘Diocese of Down and Dromore Sundry Funds)

BIBLE BLAST will include worship, bible teaching, discussion and prayer.

During these times we will be exploring the theme ‘All of You’ and how God calls every aspect of you to follow him. Our key verse is Deuteronomy 6:5, and we will be looking at how Paul lived this out.

DEVOTIONS will be where we break into smaller groups to talk about what we have learned about life and God and to pray together.

GROUP ACTIVITIES these will be activities and team challenges based around the Kilbroney centre that campers will get to do together as a group.

EVENING EVENTS will be for everyone and include a campfire, glow stick walk, movie and wide games.

COST:

£39 pp Includes all activities, food and accommodation.

CONSENT FORM I confirm that I have given consent for my son/daughter: ____________________________________________________________ to attend Kilbroney Weekend Blast to be held in the Kilbroney Centre, Rostrevor from the 4th to the 6th of November 2016.

In the event of my son/daughter being taken ill or injured during the period of camp so that surgical operation or serum injection becomes necessary, I hereby authorise the leader in charge to sign on my behalf any written forms of consent required, provided that the delay necessitated to obtain my permission might endanger my son’s/daughter’s health or safety. I also give consent for my child to receive necessary first aid or treatment deemed necessary.

YES NO I permit my child’s image to be taken for the Weekend Blast gallery and publicity.

YES

NO

I understand that some activities will involve some risk and give permission for my child named above to take part in activities.

YES NO