Weekend of Refreshing 2026 • Playford Uniting Church

Friday Evening - Sunday Afternoon (Adult or Child 12+) 0

First Name *

Email Address

Medicare Number *

Last Name *

Do you need transport to the camp?

yes

no

Do you have any special accommodation requirements (We will do our best to meet them)?

yes

no

Please specify

Do you have specific dietary requirements? If yes, please specify below

yes

no

Please specify

Do you have any allergies?

yes

no

Please specify

Will you be bringing your own tent or caravan?

yes

no

Please provide an emergency contact name *

Emergency contact phone number *

Photos and Videos:

Please note, photos will be taken over the course of the weekend and may be used in future promotional material, posted on the church website or social media pages. No names will be linked to the photos. If you do not wish to be photographed this will be respected

Do you consent for photos and/or videos to be taken & used in church publications or the Internet *

yes

no

Privacy Information:

All the information recorded on this form is collected and managed in accordance with the Uniting Church Privacy Policy. This information has been collected for the primary purpose of Playford Uniting Church and may be used for any activities, conducted or promoted by Playford Uniting Church. If you do not want this information to be used for any other purpose other than the camp, please let us know.

Friday Evening - Sunday Afternoon (Child 6-11) 0

First Name *

Email Address

Medicare Number *

Last Name *

Do you need transport to the camp?

yes

no

Do you have any special accommodation requirements (We will do our best to meet them)?

yes

no

Please specify

Do you have specific dietary requirements? If yes, please specify below

yes

no

Please specify

Do you have any allergies?

yes

no

Please specify

Will you be bringing your own tent or caravan?

yes

no

Please provide an emergency contact name *

Emergency contact phone number *

Photos and Videos:

Please note, photos will be taken over the course of the weekend and may be used in future promotional material, posted on the church website or social media pages. No names will be linked to the photos. If you do not wish to be photographed this will be respected

Do you consent for photos and/or videos to be taken & used in church publications or the Internet *

yes

no

Privacy Information:

All the information recorded on this form is collected and managed in accordance with the Uniting Church Privacy Policy. This information has been collected for the primary purpose of Playford Uniting Church and may be used for any activities, conducted or promoted by Playford Uniting Church. If you do not want this information to be used for any other purpose other than the camp, please let us know.

Friday Evening - Sunday Afternoon (Child 0-5) 0

First Name *

Email Address

Medicare Number *

Last Name *

Do you need transport to the camp?

yes

no

Do you have any special accommodation requirements (We will do our best to meet them)?

yes

no

Please specify

Do you have specific dietary requirements? If yes, please specify below

yes

no

Please specify

Do you have any allergies?

yes

no

Please specify

Will you be bringing your own tent or caravan?

yes

no

Please provide an emergency contact name *

Emergency contact phone number *

Photos and Videos:

Please note, photos will be taken over the course of the weekend and may be used in future promotional material, posted on the church website or social media pages. No names will be linked to the photos. If you do not wish to be photographed this will be respected

Do you consent for photos and/or videos to be taken & used in church publications or the Internet *

yes

no

Privacy Information:

All the information recorded on this form is collected and managed in accordance with the Uniting Church Privacy Policy. This information has been collected for the primary purpose of Playford Uniting Church and may be used for any activities, conducted or promoted by Playford Uniting Church. If you do not want this information to be used for any other purpose other than the camp, please let us know.

Saturday Morning - Sunday Afternoon - staying 1 night (Adult/Child 12+) 0

First Name *

Email Address

Medicare Number *

Last Name *

Do you need transport to the camp?

yes

no

Do you have any special accommodation requirements (We will do our best to meet them)?

yes

no

Please specify

Do you have specific dietary requirements? If yes, please specify below

yes

no

Please specify

Do you have any allergies?

yes

no

Please specify

Will you be bringing your own tent or caravan?

yes

no

Please provide an emergency contact name *

Emergency contact phone number *

Photos and Videos:

Please note, photos will be taken over the course of the weekend and may be used in future promotional material, posted on the church website or social media pages. No names will be linked to the photos. If you do not wish to be photographed this will be respected

Do you consent for photos and/or videos to be taken & used in church publications or the Internet *

yes

no

Privacy Information:

All the information recorded on this form is collected and managed in accordance with the Uniting Church Privacy Policy. This information has been collected for the primary purpose of Playford Uniting Church and may be used for any activities, conducted or promoted by Playford Uniting Church. If you do not want this information to be used for any other purpose other than the camp, please let us know.

Saturday Morning - Sunday Afternoon - staying 1 night (Child 6-11) 0

First Name *

Email Address

Medicare Number *

Last Name *

Do you need transport to the camp?

yes

no

Do you have any special accommodation requirements (We will do our best to meet them)?

yes

no

Please specify

Do you have specific dietary requirements? If yes, please specify below

yes

no

Please specify

Do you have any allergies?

yes

no

Please specify

Will you be bringing your own tent or caravan?

yes

no

Please provide an emergency contact name *

Emergency contact phone number *

Photos and Videos:

Please note, photos will be taken over the course of the weekend and may be used in future promotional material, posted on the church website or social media pages. No names will be linked to the photos. If you do not wish to be photographed this will be respected

Do you consent for photos and/or videos to be taken & used in church publications or the Internet *

yes

no

Privacy Information:

All the information recorded on this form is collected and managed in accordance with the Uniting Church Privacy Policy. This information has been collected for the primary purpose of Playford Uniting Church and may be used for any activities, conducted or promoted by Playford Uniting Church. If you do not want this information to be used for any other purpose other than the camp, please let us know.

Saturday Morning - Sunday Afternoon - staying 1 night (Child 0-5) 0

First Name *

Email Address

Medicare Number *

Last Name *

Do you need transport to the camp?

yes

no

Do you have any special accommodation requirements (We will do our best to meet them)?

yes

no

Please specify

Do you have specific dietary requirements? If yes, please specify below

yes

no

Please specify

Do you have any allergies?

yes

no

Please specify

Will you be bringing your own tent or caravan?

yes

no

Please provide an emergency contact name *

Emergency contact phone number *

Photos and Videos:

Please note, photos will be taken over the course of the weekend and may be used in future promotional material, posted on the church website or social media pages. No names will be linked to the photos. If you do not wish to be photographed this will be respected

Do you consent for photos and/or videos to be taken & used in church publications or the Internet *

yes

no

Privacy Information:

All the information recorded on this form is collected and managed in accordance with the Uniting Church Privacy Policy. This information has been collected for the primary purpose of Playford Uniting Church and may be used for any activities, conducted or promoted by Playford Uniting Church. If you do not want this information to be used for any other purpose other than the camp, please let us know.

Saturday Only - including lunch and dinner (Adult/Child 12+) 0

First Name *

Email Address

Medicare Number *

Last Name *

Do you need transport to the camp?

yes

no

Do you have any special accommodation requirements (We will do our best to meet them)?

yes

no

Please specify

Do you have specific dietary requirements? If yes, please specify below

yes

no

Please specify

Do you have any allergies?

yes

no

Please specify

Will you be bringing your own tent or caravan?

yes

no

Please provide an emergency contact name *

Emergency contact phone number *

Photos and Videos:

Please note, photos will be taken over the course of the weekend and may be used in future promotional material, posted on the church website or social media pages. No names will be linked to the photos. If you do not wish to be photographed this will be respected

Do you consent for photos and/or videos to be taken & used in church publications or the Internet *

yes

no

Privacy Information:

All the information recorded on this form is collected and managed in accordance with the Uniting Church Privacy Policy. This information has been collected for the primary purpose of Playford Uniting Church and may be used for any activities, conducted or promoted by Playford Uniting Church. If you do not want this information to be used for any other purpose other than the camp, please let us know.

Saturday Only - including lunch and dinner (Child 6-11) 0

First Name *

Email Address

Medicare Number *

Last Name *

Do you need transport to the camp?

yes

no

Do you have any special accommodation requirements (We will do our best to meet them)?

yes

no

Please specify

Do you have specific dietary requirements? If yes, please specify below

yes

no

Please specify

Do you have any allergies?

yes

no

Please specify

Will you be bringing your own tent or caravan?

yes

no

Please provide an emergency contact name *

Emergency contact phone number *

Photos and Videos:

Please note, photos will be taken over the course of the weekend and may be used in future promotional material, posted on the church website or social media pages. No names will be linked to the photos. If you do not wish to be photographed this will be respected

Do you consent for photos and/or videos to be taken & used in church publications or the Internet *

yes

no

Privacy Information:

All the information recorded on this form is collected and managed in accordance with the Uniting Church Privacy Policy. This information has been collected for the primary purpose of Playford Uniting Church and may be used for any activities, conducted or promoted by Playford Uniting Church. If you do not want this information to be used for any other purpose other than the camp, please let us know.

Saturday Only - including lunch and dinner (Child 0-5) 0

First Name *

Email Address

Medicare Number *

Last Name *

Do you need transport to the camp?

yes

no

Do you have any special accommodation requirements (We will do our best to meet them)?

yes

no

Please specify

Do you have specific dietary requirements? If yes, please specify below

yes

no

Please specify

Do you have any allergies?

yes

no

Please specify

Will you be bringing your own tent or caravan?

yes

no

Please provide an emergency contact name *

Emergency contact phone number *

Photos and Videos:

Please note, photos will be taken over the course of the weekend and may be used in future promotional material, posted on the church website or social media pages. No names will be linked to the photos. If you do not wish to be photographed this will be respected

Do you consent for photos and/or videos to be taken & used in church publications or the Internet *

yes

no

Privacy Information:

All the information recorded on this form is collected and managed in accordance with the Uniting Church Privacy Policy. This information has been collected for the primary purpose of Playford Uniting Church and may be used for any activities, conducted or promoted by Playford Uniting Church. If you do not want this information to be used for any other purpose other than the camp, please let us know.

Sunday Only - including lunch (Adult/Child 12+) 0

First Name *

Email Address

Medicare Number *

Last Name *

Do you need transport to the camp?

yes

no

Do you have any special accommodation requirements (We will do our best to meet them)?

yes

no

Please specify

Do you have specific dietary requirements? If yes, please specify below

yes

no

Please specify

Do you have any allergies?

yes

no

Please specify

Will you be bringing your own tent or caravan?

yes

no

Please provide an emergency contact name *

Emergency contact phone number *

Photos and Videos:

Please note, photos will be taken over the course of the weekend and may be used in future promotional material, posted on the church website or social media pages. No names will be linked to the photos. If you do not wish to be photographed this will be respected

Do you consent for photos and/or videos to be taken & used in church publications or the Internet *

yes

no

Privacy Information:

All the information recorded on this form is collected and managed in accordance with the Uniting Church Privacy Policy. This information has been collected for the primary purpose of Playford Uniting Church and may be used for any activities, conducted or promoted by Playford Uniting Church. If you do not want this information to be used for any other purpose other than the camp, please let us know.

Sunday Only - including lunch (Child 6-11) 0

First Name *

Email Address

Medicare Number *

Last Name *

Do you need transport to the camp?

yes

no

Do you have any special accommodation requirements (We will do our best to meet them)?

yes

no

Please specify

Do you have specific dietary requirements? If yes, please specify below

yes

no

Please specify

Do you have any allergies?

yes

no

Please specify

Will you be bringing your own tent or caravan?

yes

no

Please provide an emergency contact name *

Emergency contact phone number *

Photos and Videos:

Please note, photos will be taken over the course of the weekend and may be used in future promotional material, posted on the church website or social media pages. No names will be linked to the photos. If you do not wish to be photographed this will be respected

Do you consent for photos and/or videos to be taken & used in church publications or the Internet *

yes

no

Privacy Information:

All the information recorded on this form is collected and managed in accordance with the Uniting Church Privacy Policy. This information has been collected for the primary purpose of Playford Uniting Church and may be used for any activities, conducted or promoted by Playford Uniting Church. If you do not want this information to be used for any other purpose other than the camp, please let us know.

Sunday Only - including lunch (Child 0-5) 0

First Name *

Email Address

Medicare Number *

Last Name *

Do you need transport to the camp?

yes

no

Do you have any special accommodation requirements (We will do our best to meet them)?

yes

no

Please specify

Do you have specific dietary requirements? If yes, please specify below

yes

no

Please specify

Do you have any allergies?

yes

no

Please specify

Will you be bringing your own tent or caravan?

yes

no

Please provide an emergency contact name *

Emergency contact phone number *

Photos and Videos:

Please note, photos will be taken over the course of the weekend and may be used in future promotional material, posted on the church website or social media pages. No names will be linked to the photos. If you do not wish to be photographed this will be respected

Do you consent for photos and/or videos to be taken & used in church publications or the Internet *

yes

no

Privacy Information:

All the information recorded on this form is collected and managed in accordance with the Uniting Church Privacy Policy. This information has been collected for the primary purpose of Playford Uniting Church and may be used for any activities, conducted or promoted by Playford Uniting Church. If you do not want this information to be used for any other purpose other than the camp, please let us know.

Date & Time

Friday Evening - Sunday Afternoon (Adult or Child 12+) 0

Friday Evening - Sunday Afternoon (Child 6-11) 0

Friday Evening - Sunday Afternoon (Child 0-5) 0

Saturday Morning - Sunday Afternoon - staying 1 night (Adult/Child 12+) 0

Saturday Morning - Sunday Afternoon - staying 1 night (Child 6-11) 0

Saturday Morning - Sunday Afternoon - staying 1 night (Child 0-5) 0

Saturday Only - including lunch and dinner (Adult/Child 12+) 0

Saturday Only - including lunch and dinner (Child 6-11) 0

Saturday Only - including lunch and dinner (Child 0-5) 0

Sunday Only - including lunch (Adult/Child 12+) 0

Sunday Only - including lunch (Child 6-11) 0

Sunday Only - including lunch (Child 0-5) 0