@ El Shaddai Camping Centre, El Shaddai Rd, Wellington SA 5259

You will need to complete a Medical and Consent Form for all attendees
(each participant adults & children)

Question Title

* 1. Contact details

Question Title

* 2.  Allergies and special diet                                  TSAA endeavours to organise through caterer safe, healthy meals to all clients, including those with special dietary needs.
Those at risk from food related anaphylaxis require the highest level of care. It is important that we receive information
regarding food related allergies even if the participant is
attending a self-catered program.
If the participant has a special dietary need, please provide information below. If not applicable, select n/a.
Food related anaphylaxis diagnosed by a doctor. Please indicate prescription and the item/s the participant CANNOT eat. Please note: If any of this
section is completed, you MUST provide a doctor-certified action plan to
TSAA (info@tourette.org.au) 6 weeks prior to camp.

Question Title

* 3. Food related allergy or intolerance. Please indicate the item/s the participant CANNOT eat - allergy or intolerance
If not applicable, select n/a.

Question Title

* 4. Food related allergies/aversion/religious beliefs/
lifestyle choice. Please indicate the participant’s special diet. 
If not applicable, select n/a.

Question Title

* 5. Non-food related allergy. Please indicate the participant’s non-food related allergy.
If not applicable, select n/a.

Question Title

* 6. Does the participant have any of the following
(If not applicable, select n/a.)

Question Title

* 7. Medicare Number

T