Camper Enquiry

Submitted by admin on Fri, 04/07/2014 - 12:53pm

If you would like more information about being a camper at Camp Cooinda, please fill out the form below. Please check the Summer Camps page and the Frequently Asked Questions page prior to sending the form as they may answer your query.

Please enter the name, date of birth and email address of the parent/guardian completing this form. This information allows us to identify the right "John Smith" in our database. In the comments box, you can provide the name and other information about the camper(s) your inquiry relates to.

First Name *

Last Name *

Email *

Gender

Birth Date *

Day

Month

Year

Mobile Phone Number

Please include spaces (eg 0412 345 678)

Home Phone Number

Please include spaces (e.g. 03 9876 5432)

Street Address *

Street Address Line 2

City *

State/Province *

Postal Code *

Country *

Refer Source *

Please select how you first found out about Camp Cooinda?

Your enquiry *

Please add a few words here to help us understand your enquiry (e.g. Please let me know when applications are open for next summer).

Leave this field blank