Thank You!

Thank you for serving at the Springtime Immaculata Mission School. We are very grateful for your support. This short form collects information required for safeguarding purposes and helps us ensure that your needs, including any dietary, medical, or accommodation requirements, can be appropriately catered for during IMS.

I am a: *
Role
Name *
Name
Gender *
Date of Birth *
Date of Birth
Address *
Address
Email *
Mobile Number *
Home Phone Number
Emergency Contact Name *
Next of kin or relative
Emergency Contact Number *
Emergency Contact Email *
Do you have any Health Conditions? *

Please note: Participants with asthma and/or anaphylaxis must provide a current GP-signed Asthma Action Plan and/or Anaphylaxis Action Plan, prior to the commencement of IMS. These plans help us provide safe and appropriate care during the event. Please email the relevant plan(s) to immaculatamissionschool@gmail.com prior to IMS.

Please also ensure that your asthma reliever medication and/or EpiPen/Anapen is brought to IMS and presented at registration upon arrival. These medications will be sighted at registration and must be kept with you at all times throughout IMS.

Do you take any Medication?
Please provide details of any medication you are currently taking
Do you have any Dietary Requirements? *
Do you require accommodation on-site? *
Do you have any special requirements (e.g. accommodation needs) or other important information we should be aware of?
Please upload a recent headshot of yourself *
Drag & Drop Files, Choose Files to Upload
These are for use only by our admin team for safety purposes, so we can easily identify participants. Accepted file types: JPG, JPEG, PNG

Safeguarding

What is your approximate day and time of arrival? *
Arrival
What is your approximate day and time of departure? *
Departure

IMS Waiver

Medical Treatment Consent *

I give permission for the Immaculata Community to obtain emergency medical, hospital or ambulance assistance and/or treatment for myself at any time they consider necessary. I acknowledge that I will be liable for any medical, hospital or ambulance expense incurred in my treatment and I agree to pay those expenses.

Medical Consent