Braille Music Camp Student Registration Form • Variety - the Children's Charity of Queensland

Your name*

First Last

Your email*

Please enter your best contact email to receive suggestive packing lists and other info on the camp.

Your phone number*

Your child's name*

First Last

Your child's date of birth*

Your child's gender*

Female
Male
Other

Please describe your gender*

Name of school your child attends*

Name of your child’s AVT/Vision Support Teacher*

Name of your child's music teacher

Do you require support for any medical conditions that may affect your level of participation on camp?

If so, please list medical conditions.

Do you require support for administration of any medication you take?*

Yes
No

Please list support required.*

Please list and explain the type of medication, dosage, time/s taken, storage and how it is taken.

Dietary requirements*

Please list any dietary requirements including vegetarian, vegan, gluten free or other.

Child's shirt size*

Tell us a bit about yourself*

Please include information including whether your child can read braille music or has experience with it, If they play any instruments or would like to learn, If your child receives private music lessons or school instrumental lessons, your child's favourite type of music, etc.

What have been roadblocks (if any) to your child learning braille music?

In addition to orientation and mobility support/guidance associated with having a vision impairment, does your child need extra assistance / specialised care at Camp?

Note: all showering and hygiene needs will be supported by trained vision support and special needs teachers.

What are your expectations for the camp?*

Select All
Safe environment
Safe involvement
Educational benefits
Professional/specialised support
Friendships
Self-advocacy skills
Practice of independent life skills

What are your top concerns in registering your child in this camp?*

Select All
Staff qualifications
Travel
Level of camp support available
Bullying
Staff/camper communication
Follow up support in educational settings

Are you interested in sponsorship opportunities?

If yes, please provide your name, email address, contact number and sponsorship proposal.

Please upload a headshot photo of your child. This will help us put a face to a name!*

Accepted file types: jpg, jpeg, png, gif.

Please review*

I accept the terms of the Variety Braille Music Camp Waiver

I acknowledge that my child will be tested for Covid-19*

I accept that my child will have a Rapid Antigen Test (RAT) provided by Variety on the day of the camp before attendance, and may also be tested each morning of the camp to ensure the highest level of care for all campers is upheld.

2022 Variety Braille Music Camp registration fee inclusions:

Flights if required (children 9-17 years only)
Meals
Accomodation
Supervision and support by qualified VI teachers and music teachers
Braille music lessons
Music computer software lessons
Workshops delivered by professionals working in the music industry

2022 Registration Fee
Full rate of $100 applies to all payments. This $100 fee is the only cost involved for your child to enjoy the full braille music camp experience.

Registration Fee

Quantity

First Name*

Surname*

First Name*

Surname*

First Name*

Surname*

First Name*

Surname*

Total

$ 0.00

Secure Credit Card Payment*

American Express

MasterCard

Visa

Card Number Expiration Date Security Code Cardholder Name

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Please Note

All staff, volunteers, parents and participants who are 16 or older will need to be fully vaccinated (2 vaccination doses) against Covid-19 unless a medical exemption card is provided. You will be required to show proof of your vaccination status or medical exemption via the Check In Queensland app to attend the Variety Braille Music Camp. This is due to requirements placed upon our host venue by the QLD Government. This will also include anyone over the age of 16 who will be attending the Camp Concert in the Auditorium on Night 3.

Submission Note

Once you’ve checked all your required details are entered correctly, please press submit only once and wait for your payment confirmation to process. Check your inbox for a confirmation email. If this has not been received, check your junk folder. If you receive a page error, please still check your email inbox and junk folder as we may still have received your registration. Feel welcome to reach out to Variety to confirm if your registration is submitted successfully.