2024 Pre-Training Registration Form "*" indicates required fields Training Registration Form Complete the below pre-training registration form in order to finalise your enrolment. Tip: If you run out of time, use the Save & Continue Later button at the bottom of the form to continue later.Your DetailsFull Name* First Last Email Address*Make sure this is 100% accurate and the same email you purchased your training registration with. Phone Number*Enter your best contact number. Training Level*Which training level did you purchase?Please selectLevel 1Level 2Training Dates*Select the date of the training you purchased.Please select8-10 Mar 202426-28 Jul 20246-8 Sep 202425-27 Oct 202414-17 Nov 2024What is your reason for booking this training?*Date of Birth*Day12345678910111213141516171819202122232425262728293031Month123456789101112Year2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Gender*MaleFemaleOtherTraveling From*Which city/suburb are you traveling from? Postcode*What is the postcode of this city/suburb? Dietary Requirements*Provide details of dietary requirements and food allergies.Medical Conditions*Provide details of all Medical Conditions, including medication, dosages and triggers.Occupation*What is your occupation? Business/Organisation*What organisation do you belong to / work for? How did you hear about this our training?*WebsiteSocial MediaWord of MouthTV/RadioOtherAdditional InformationNeed to let us know of anything else?Emergency ContactEmergency Contact Full Name*This person will be contacted in case of an emergency. First Last Emergency Contact Phone Number*Enter the emergency contact's best contact number. Camping EquipmentWould you like to purchase a camping kit from us?*Our camping equipment kits cater for two people. Select an option below if you'd like to purchase one today.Please select an optionI'll supply my ownYes, I'd like to purchase one nowOur Camping Kits $100 - Full Camping Kit (1 x Tent, 2 x Stretchers, 2 x Pillows, 2 x Sleeping Bags $50 - Tent Only (1 x Tent) $25 - Pillows & Sleeping Bags Only (2 x Pillows, 2 x Sleeping Bags) $25 - Stretchers Only (2 x Stretchers) NewsletterOpt-in to our newsletter?*Would you like to keep up-to-date on everything new? We'll send new and upcoming events straight to your inbox.Please select an optionYesNoTerms & ConditionsDo you accept the following Terms & Conditions?*I hereby state that I have read and agree to the following: Booking amendments: We understand that sometimes, things happen which may impact your ability to attend our programs. If you need to make changes more than 12 weeks before the program, we will charge a $50 administration fee. Between 6-12 weeks before the program commences, changes will be subject to a cancellation fee equivalent to 10% of the total program cost. As our programs sell out far in advance, we are unable to offer refunds or credit transfers for any reason within six weeks of the commencement of the program, unless we can rebook the space with another participant. For this reason, we strongly encourage you to take out domestic travel insurance which will cover you in the event you need to cancel or postpone the program for most reasons outside of your control. Policies can cost as little as $35-70 and cover airfares, accomodation and program costs. You should undertake your own research to find a policy that suits you however one we recommend looking at is Insure and Go. A Silver Level cover includes up to $10,000 for accomodation, airfares and program costs and has a $100 excess. If you call them and ask for Jesse and mention the referral loyalty discount from the Rites of Passage, you will also receive a 10% discount. You can see more by visiting https://www.insureandgo.com.au Photo release: The Rites of Passage Institute may, from time to time, capture images, video and audio on camps and use this for promotional purposes. You may opt out of being filmed or photographed either in person whilst on camp, or by emailing info@ritesofpassageinstitute.org. Responsibility: I declare that I am taking part in a workshop or training offered by The Rites of Passage Institute, of my own free will. I agree to follow the rules and instructions of the workshop or training, given by the facilitator, and I agree to take full responsibility for my actions during my attendance. Health and Safety: I hereby declare that I am not suffering from any psychological or physical illnesses that could put myself, other participants, or the facilitators in any danger, or harm’s way. The Rites of Passage Institute has a Health and Safety protocol including a COVID safety plan in line with government recommendations. I agree to follow the directions of the Rites of Passage Institute. Consent: I, being the participant and, where applicable, the parent/guardian of a child attending a camp, declare that I understand that the activities may involve running and jumping as well as being in the bush, thus exposing myself and my child (where applicable) to situations and physical activities that have an element of risk. I acknowledge that there will be every reasonable effort made to minimise exposure to known risks. However, all hazards and dangers associated with these activities cannot be foreseen or may be beyond the control of staff. I acknowledge that this camp will be held in a bush environment and while every effort is made to ensure the safety and well being of me and my child (where applicable), there is always a possibility of sickness or injuries occurring. There will be trained first aid staff on the camp but for any serious medical issues that may arise, there is an evacuation procedure which includes any affected participant being transferred to the nearest hospital. In the event of an ambulance being required or extra medical fees arising, they will be the responsibility of the participant. Confidentiality: To protect the privacy of all participants, I agree to maintain confidentiality about the process and information I come to know during this event. I will respect the identity and privacy of all individuals attending this workshop, or training. In the event of unforeseen circumstances, The Rites of Passage Institute reserves the right to change or cancel camps. AcceptedCoupon Code I have a coupon code Coupon Credit CardCard Details Cardholder Name Total (including GST) CommentsThis field is for validation purposes and should be left unchanged. Comments are closed.
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