Horizon Counsellor Registration

Consent

By registering as a Counsellor at Camp Horizon, I agree to disclose personal information as defined by the Privacy Act 1988 (Cth). Under the Privacy Act, the National Institutions must inform you of the following information about storing your personal information.

Organisation contact details: Social Development Inc Pty Ltd, [email protected].

Social Development Inc collects personal and health information for registration to Camp Horizon. The purpose of Camp Horizon is to encourage participants to try new experiences, emphasise the importance of a healthy and balanced lifestyle, enhance participants’ self-esteem, critical thinking and teamwork skills, and encourage expression and creativity.

If personal and health information is not collected, the planning and implementation of Camp Horizon will not be able to be carried out effectively. Social Development Inc must have this information on hand to, amongst other things, communicate with you during the planning and implementation of Camp Horizon, ensure your safety and security, provide you with efficient medical treatment at the camp site if necessary, and ensure the content of the camp is suitable and catered appropriately to specific cohorts of participants.

Information provided to Social Development Inc will not be disclosed to any third party without your express consent.

Social Development Inc’s privacy policy allows you to access your information anytime to make changes as required. You may contact [email protected] to arrange this access.

Social Development Inc’s privacy policy allows you to file a complaint if you believe Social Development Inc has breached any Australian Privacy Principles. In addition, you may refer any difference or dispute to The Conciliation and Arbitration Board, having jurisdiction under the constitution of The Shia Imami Ismaili Muslims.

Social Development Inc will only disclose information to overseas persons with your express consent.

All information collected is securely stored in an electronic database. Only the members of the core project implementation team of Camp Horizon will have access to this information.

In the event of a medical emergency, I hereby authorize emergency treatment to be administered to me by a qualified staff member. I also give permission for myself to be transported by ambulance to an emergency centre or hospital if needed. I consent to medical treatments and procedures to be performed on me by a licensed physician or hospital when deemed immediately necessary or advisable by the physician to safeguard my health. I further accept responsibility for all expenses incurred for my medical treatment in case of an emergency.

I have read this consent and release form and I understand that my personal and medical information is being collected for Camp Horizon, and that I must supply this information in order to participate in the Camp. I am obliged to correct and update my personal and medical information where it has changed, and I accept full responsibility for any loss or injury resulting from the reliance upon old or inaccurate information I provide. I also have a right to access and view the supplied personal and medical information in accordance with the provisions of the relevant privacy legislation.

I understand the commitment required of me as a Camp Horizon Counsellor. I agree to be available for the dates and times agreed upon. I also agree to attend the mandatory Counsellor Orientation before the Camp.

I release, indemnify and hold harmless His Highness Prince Aga Khan Shia Imami Ismaili Council for Australia and New Zealand (“the Council”), its portfolios, members, staff, volunteers and agents, including all staff whatsoever, and I give permission for the local Health Portfolio Team and certified nurses at the venue to tend to my needs.

I confirm that I have read and agree to the terms.