Teen Programs Registration

Youth (12-17) Registration

Step 1 of 5

The healing program will be confirmed once we have received your registration form and initial registration fee.

PLEASE do not make any travel or work arrangements until you have received an email confirmation from us.

Registration Form: it’s important that this is filled in with your child attending.

(THIS INFORMATION IS CONFIDENTIAL UNLESS DUTY OF CARE REQUIRES DISCLOSURE)

KEY SAFETY PRINCIPLES

It is so important to us that Kids Kamp is a safe place for everyone. While you are here, there are some safety agreements that we all have to commit to.

I agree that CONFIDENTIALITY is really important and I agree not to tell anyone anything about other guests’ or carers’ backgrounds, their stories or what has happened to them as it is really important so that I and everyone else can feel safe to be vulnerable and honest.

I agree to tell the facilitator or carers if anything happens that makes me feel uncomfortable while I am here so that I feel safe at all times.

I understand that illegal drugs/alcohol or herbal mind-altering substances are not allowed here at all and I agree to not bring them with me or use them while I am here. I understand that if I do use any of these things while I am here, I will be asked to leave immediately.

I agree to not leave the property during the healing week. If you leave the property for any reason during the week you will be unable to complete that particular healing week. This is because we have found that taking breaks from the Healing Week is disruptive and can distract not just you but also your fellow guests from healing. You will be welcome to attend a healing week at another time.
I am committed to my healing and will avoid distractions. It’s important to be here for yourself and not to satisfy family members or others. We ask that you avoid distractions so that you can enter into the healing week, and receive the maximum benefit. For this reason there are no TVs, newspapers, radios, magazines or games. We ask that you do not bring novels, laptops or bring any of your usual work or study with you as it might distract you, and others, from healing.

I understand and accept that I will not be able to keep or use my mobile phone during the week. Group safety is our first concern and we have found that if any guest uses a mobile phone during the week, it breaks the sense of safety for everyone. We have also found that it is hard to concentrate on yourself if you are phoning family, friends or work colleagues. We will therefore ask you to leave your mobile phone in our care during the week. Of course if there is a special need, we are happy to discuss this with you. As you will not be able to use your mobile as an alarm or to play music, we suggest you bring an alarm clock with you. IPod or MP3 players are only to be used at night to help you sleep. Earphones to be used at all times.

I understand that if I self harm I may be asked to leave. Self-harm is a way some of us abuse ourselves. Our healing program is designed to help you develop alternative effective coping mechanisms.

I understand that sexualised behaviour is inappropriate here. Sexual behaviours are not just about sex. They include any talk, touch, questions, conversations and interests which relate to sexuality and relationships. So that everyone can feel safe and focus on their healing, we ask that there be no sexualised behaviour including nudity or partial nudity; no sexual activity; kissing; flirting; sexual jokes or innuendos during the healing program.

I understand that if I behave in an unsafe manner I may be asked to leave. I have provided the name of an emergency contact person you can contact if this is the case. Although very rare, occasionally we have had to ask guests to leave as abuse of any kind is not tolerated. This includes swearing or shouting at someone, derogatory comments or using intimidating body language. Heal For Life Foundation is committed to providing a safe place for survivors who did not experience a sense of safety in childhood. It is vital that all members of the group work together peacefully and lovingly and take full responsibility for their part in any conflict.
Name*
First Last
I agree with all of the key safety principles above*
- Click in the box to indicate yes you agree and click Next to continue your registration

Please answer the following questions:

PLEASE NOTE; Questions marked with an asterisk (*) are required.

For the parent/guardian to sign by filling out your name in the below box:

1. I understand that I will need to attend a session myself at Heal For Life on the first and last day of the healing program to best support my child. I understand that if I do not attend these sessions, my child may be refused to attend.

I also understand if my child is unable to participate in the group safely, then Heal For Life may have to ask them to leave the program early, in which case I will be available to collect my child.

I have read and understand all the information in relation to the healing program and explained the relevant information to my child

Please ask your child to fill in this question, as your child who needs to know what the program is about and be happy to attend.
Why do you want to come to Heal For Life?*
Name of Parent/Guardian*

Your healing program will be confirmed once you have sent your Initial Registration Fee payment.

PLEASE do not make any travel or work arrangements until you have received a letter or email confirmation from us.

Cancellation / Deferral:

We often have a waiting list for our programs. If you cancel, defer or do not come to a confirmed place this may prevent someone else from attending. Please tick that you have read and understand the following:

1. I accept that if I cancel or defer after confirmation has been received, my Initial Registration Fee is not refundable.

2. If I cancel/ defer within 7 days of the program start date I understand that I am committed to complete the payment option I have chosen as it will have prevented someone else from attending.

3. If I choose to leave the program or if I am asked to leave prior to its completion I understand that I am committed to complete the payment option I have chosen.
Yes*
I have read and understand the above cancellation/deferral details.

The following fee covers accommodation, all workshops and workshop materials during the program. Heal For Life is committed to making our program available to anyone in need regardless of current income. However we receive no Government funding and we wish to remain independent. We are very grateful to those who can afford to pay the whole fee.

We offer monthly payments to make it easier for you. If however you have any problems with any of these options please call us on 02 4998 6003.

The following fee covers 5 nights’ accommodation and all workshops during the program. We wish to keep our program as affordable as possible and trust you will opt to pay the fee that best meets your financial situation.
Please select one of the following:*
Upfront Payment*
Price: $ 1,500.00
Once we have received your initial registration fee and registration details, we can confirm your place in the program.

Sponsored places – on each programme we have a limited number of sponsored places which can cover all or part of the total fee - If this would better fit your financial circumstances please contact the Office.

* Limited sponsored places are available - please contact our office (02) 4998 6003

Youth (12-17) Registration

Step 1 of 5

Free Chapter Download

Heal For Life – Chapter 2:
Defining Trauma & Self Healing

Free Download of Chapter 2

Youth (12-17) Registration

Step 1 of 5

Free Chapter Download

Heal For Life – Chapter 2:Defining Trauma & Self Healing

Free Download of Chapter 2

Heal For Life – Chapter 2:
Defining Trauma & Self Healing