AYCC and Seed State Training Registration Form 2017

Thanks for your interest in attending the AYCC and Seed Victorian Training Summit!

The VIC Training Camp will be held from Friday the 24th to Sunday the 26th of November at the Eumeralla Scout Camp in Anglesea. The training camp will include loads of organising and campaigning skills and will help you to build your knowledge of how to get involved in action on climate justice, as well as some time to chill out with like-minded young people.

If you have any additional questions about the camp feel free to contact either Indi Narain (AYCC) 0413 476 146 or Ilana Cherny (AYCC) 0424 916 565.

This registration form should only take 10 minutes to fill out.
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Name: *

 
Phone Number *

 
Do you identify as Aboriginal or Torres Strait Islander? *

     
 
Preferred personal pronoun:

(e.g. he, she, they)
 
What is your date of birth? *

If you are under 18 we will be sending you a guardian consent form to get signed by the appropriate adult. 

 
This year we will be camping at Eumeralla, do you have access to a tent?

     
 
If yes, would you have room to share with individuals that do not have a tent?


 
Do you have any accomodation preferences? (e.g. same gender, sharing with a specific person etc.)

 
Do you have any dietary requirements? *

 
Do you have any allergies? *

If so, please specify...
 
Do you have any medical conditions we need to know about? *

 
Emergency contact details:

 
Name: *

 
Phone number: *

 
Relationship to you:

 
What has your involvement in Seed or AYCC been in 2017? *


 
What skills/content do you want to get from the training camp? *


 
Do you have any skills you would like to share with the group?

 
The venue will be Eumeralla Scout Camp in Anglesea and public transport will not take you straight to the venue. However, we may be able to organise carpooling. Please let us know if you have a car and would be willing to provide transport to fellow volunteers.


 
Ticketing

At the AYCC and Seed we don't ever want costs to be a barrier for anyone participating. However state summits do cost money and to be able to provide a sustainable program we need to charge a participation fee. In return participants receive high quality training, as well as food and the venue. We offer an unwaged ticket price for students or those without a salaried job ($30). Waged tickets are for those with salaried jobs ($45). If you feel you can't afford the concession ticket price you should contact your state mentor and request a scholarship. Seed participants are all offered a climate justice scholarship and asked to contribute however much they can. We also have a solidarity ticket which is $60, for those of you who have the means to support another participant to attend.

 
Thanks for registering for the state training!  You selected the {{answer_gAsmIaDXarGD}} ticket (Price: {{var_price}})

To complete your registration, please pay via our secure portal by debit/credit card to reserve your place at the summit.

You don't need to print your receipt, we will keep a registration list of summit participants. 

If you can not pay by card please contact Indi at indira@aycc.org.au
 
Please enter your Credit or Debit Card number:

 
The CVC number:

(3 or 4 digit security number on the back of your card)
 
The name on your card:

 
Your card's expiry month:


 
Your card's expiry year:


Thanks for filling out the AYCC VIC training camp registration form! We can't wait to see you on November 24th! If you have any questions/concerns etc please don't hesitate to contact either Indi Narain (AYCC) on 0413 476 146 or Ilana Cherny (AYCC) on 0424 916 565.
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