TwinkleToes NSW Applications CLOSED

The Twinkletoes event is a community-centric and engaging experience especially tailored for families and children with JIA under 12. Fill in the form to register. After completion you will be redirected to make payment.

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PART A – PERSONAL DETAILS OF ALL FAMILY MEMBERS ATTENDING EVENT

Name Parent/Carer Attendee 1:*
Name Parent/Carer Attendee 2:
Name of child with arthritis*
DD slash MM slash YYYY
Additional Attendee's Details:
Full name
Date of birth
Male/Female/Non Binary
Sandwich Option (as listed above)
 
More can be added by clicking the '+'
Have you attended Twinkletoes before?

Emergency Contacts

Emergency Contact*
Full name
Phone
Relationship to family
 
Your emergency contact must not be someone attending the event.

Family Needs for the Day

Does anyone attending have any dietary requirements?
Name
Dietary Requirements
 
Does anyone attending have a medical condition that may require emergency medical intervention? (e.g. asthma, epilepsy, diabetes, high or low blood pressure, fainting spells, heart problems)
Name
Medical Condition(s)
 
Does anyone attending have any known allergies (bees, pollen/plants, foods, etc.)?
Name
Allergy
Treatment/Medication
 
IF THE ALLERGY REQUIRES POTENTIAL USE OF AN EPI PEN, IT IS EXPECTED THAT YOU WILL CARRY YOUR OWN WITH YOU AT ALL TIMES AND BE ABLE TO ADMINISTER THE EPI-PEN.
Does anyone attending have any other special requirements?
Name
Requirements
 

Parent Authorisation

I/We acknowledge that the venue for the Twinkletoes event has been assessed, under The Arthritis Movement guidelines, and deemed a suitable venue.   

I/We indemnify The Arthritis Movement against any claims, should participation in any activity on this day aggravate any pre-existing condition our child/children or anyone attending may have. 

I/We will not hold The Arthritis Movement, its employees, or volunteers, responsible for any illness or injury incurred by any member of our family during The event. 

I/We indemnify The Arthritis Movement against any claims of loss or damage to personal property of our family and acknowledge that all personal property is brought to the event at our own risk. 

I/We accept financial responsibility for any damage to venue property that occurs as a result of the actions of any of the members of our family. 

I/We will not bring onto the site, nor be affected by while on the site, alcohol or any illegal substances.

The venues general conditions of hire, we recognise that the venue is a Smoke Free Environment and smoking is not permitted within any building on site.  

The personal details and health information provided has been completed correctly to the best of our knowledge.

I/We recognise that while this is a family event, there will be occasions where our child/children may be involved in activities in the absence of their parents/guardians. In these situations we consent to leave our child/children with The Arthritis Movement staff and/or volunteers.

I/We acknowledge that all The Arthritis Movement staff and Twinkletoes volunteers have completed National Criminal Record and Working with Children Checks.

I/We understand that we can remove our child/children from any activity at any time and agree to inform The Arthritis Movement staff if we do this or decide to leave this event before the conclusion of the weekend’s activities.

I/We understand that the supervision of our children is our responsibility while at Twinkletoes event except when taking part in activities where it is expressly stated by The Arthritis Movement that they assume the supervisory role.

I/We understand that while our child/children may be under the care of The Arthritis Movement staff and/or volunteers, we are ultimately responsible for the behaviour of our child/children. If a situation arises requiring our child/children to be reprimanded or disciplined, I/we agree to carry this out.

I/We recognise that Twinkletoes is an event for families with young children and will therefore behave in a manner appropriate for families.

I/We understand that, from time to time, The Arthritis Movement will contact us with various opportunities for supporting people with musculoskeletal conditions and research projects. I/We understand that The Arthritis Movement will not on-sell any personal details to any other organisation and that The Arthritis Movement complies our Privacy Policy.

Name*
MM slash DD slash YYYY

Media Consent

The Arthritis Movement seeks parental / guardian consent to use media, including but not limited to, photography and video taken at Twinkletoes. We assure you that media materials will be used in a responsible and positive manner for the purpose of promoting the organisation’s activities and to secure funding for future events. Please indicate below where you give consent for media to be used, complete your name and your child’s name and accept the consent. If you wish to withdraw this consent at any time, please contact The Arthritis Movement on 1300 275 826.
Arthritis Matters (Donor Newsletter of The Arthritis Movement)
Mainstream media (e.g. local newspapers, family magazines, radio)
The Arthritis Movement's Social Media: Facebook, Twitter, Instagram, YouTube
The Arthritis Movement Website and Newsletters
The Arthritis Movement Sponsor / Corporate Partner marketing materials (i.e. Twinkletoes funders)
Paediatric Rheumatology Network
I, (Parent/Carer Attendee 1)*
I, (Parent/Carer Attendee 2)
I, (Parent/Carer)*
permit media of my children / children in my care, to be used as indicated above. (Child's name 1)*
permit media of my children / children in my care, to be used as indicated above. (Additional Child/ren)

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