Young Adults Weekend Retreat
Youth Encounter’s young adults camps are about developing young leaders ages 17+ to have a significant impact in life. Through self-discovery, they are empowered to step into adulthood with confidence and strength in who they are.

Treat yourself to our Weekend Retreat of exploring new ideas about life, while riding dirt bikes on Saturday with golf activities on the Sunday. Bring your own dirt bike and golf clubs or enquire about using ours.

Age: young adults 17+

Friday 8th July - Sunday 10th July (arrive Friday from 4.30pm and leave Sunday 4pm)

Where: Youth Encounter Home Base, 196 Roydon Downs Road, RD 9, Paengaroa

Cost: $180

Safety: We hold an Adventure Mark safety certification. Participant’s safety is our priority on and off tracks, and their equipment needs to be up to our requirements. Find full list at https://www.youthencounter.co.nz/site_files/11361/upload_files/EC_CampersGear&EquipmentList.pdf?dl=1

Further enquiries: Any further enquires about this camp, please contact the Programme Coordinator (Tracey) on 021 599 702 or email tracey@youthencounter.co.nz
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Gender *
Full Name *
Date of birth *
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Phone numbers *
Email address *
Physical Address
I am bringing a dirt bike? *
Emergency Contacts
Please list two emergency contacts details that we can contact while you are on camp.
Emergency contacts name *
Contacts phone number *
Medical Details
Please provide the participants medical details so we can provide the best possible care for them during camp.
Do you have any medical conditions? *
If YES, please provide the details of your medical condition
May include asthma, diabetes, epilepsy, depression, migraine, chickenpox, ear infections, heart problems, fainting, dizziness, glandular fever, allergic reactions to insect bites or bee stings, food allergies, allergies or any other.
Will you be taking any medication during this event? *
If YES, please provide the details of this medication.
When was your last tetanus injection? (leave blank if unknown)
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Please provide any further information that may be helpful for us to know such as special dietary requirements etc?
RISK DISCLAIMER
1. I am aware that dirt bike riding and the other activities offered during the camp will involve an element of risk and the participant participates at their own decision and entirely at their own risk.

2. In the event of sickness or an incident I grant permission for Youth Encounter staff to assist or seek appropriate medical attention for the participant and the first available emergency contact provided will be notified promptly. I will reimburse Youth Encounter with any costs that are not covered by ACC that may be incurred and any other related expenses.

3. I give permission for the participant to be transported during a camp by Youth Encounter staff and I will not hold the driver or owner of the vehicle responsible for any injury or harm that may occur.

4. I agree that Youth Encounter staff and or land owners will be cleared of all personal liability in the event of an incident or loss of person or property occurring on their land or during the camp.

5. The participant agrees to abide by Youth Encounter's regulations set-out and will accept the consequences if this is not adhered to.  This may include  being removed from the Youth Encounter Camp without any reimbursement.

6. Youth Encounter reserves the right to withdraw a participant from an activity that we believe is likely to endanger themselves or others by their actions. We also reserve the right to cancel any activity if we become concerned for any reason.

7. I agree that photographs or video of the participant as well as identifying stories or quotes about the participant, taken during the camp, may be used for Youth Encounter's promotional and social media purposes.

8.  Youth Encounter Ministries Trust complies with the Privacy Act 1993 and all files will be kept securely and will remain confidential to the organisation; however as part of the accreditation process the Ministry of Social Development or Oranga Tamariki may have access to personal information or documentation the organisation holds.

9. I give permission for the participant to attend and participate in the Youth Encounter camp listed on this form and all the information supplied on this form is true and correct and I consent to this information being used for the purpose of running the camp and that I will advise Youth Encounter promptly of any changes.
Participant agreement *
'Participant' is the name of the person registered on this form
Registration Fee
$180 paid before camp commences.

Payment details *
Please note the details below to complete the registration.  You will be emailed an invoice after registration.                  Direct debit - BNZ account 02-0452-0048320-00
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