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Booking confirmation Form

GABC Fax: 02 4997 3144

School Details School Name :

Dudley Public School

School Address : 124 Boundary Street, DUDLEY, NSW 25290 OrganisingTeacher: Jason Horadam Alternate Contact : Fax Number: Alternate E-mail Address : E-mail: Contact Phone : 02 4944 7203

02 4942 6097

Camp Details Booked Dates : Term 4, Week 5, Monday 3rd – Wednesday 5th November 2014 Year Group Booked : Year 6 – approx. 67 students

Location Booked : Kincumber Booking made by : Jason Horadam

Acceptance Jason Horadam I _______________________ as organising teacher for the above camp confirm our booking with the Great Aussie Bush Camp. In confirming the booking I also agree to :  Respond to communication in a timely manner  Have parents/guardians fill in activity consent and liability forms for each attending student  Send all dietary and medical information through to GABC prior to camp  Bring all signed and completed activity consent and waiver forms for each attending student with me to camp and hand to office on departure. Organiser Signature :

Jason Horadam

Organiser Name: Jason Horadam

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Date :


Booking confirmation form signed