Companion Registration of Interest

If you would like to be considered for selection, please complete the form below.

Nb: Our Companion Registrar has advised that we have had an enormous response from the prospective female companions, and therefore registrations for attending our Camp 2012 are now closed for them. However, we are still looking for more male companions, so please spread the word or complete the registration form below.

... and Ladies, we still invite you to register your interest if you would like us to keep in touch regarding our next training in September 2012 for our following summer Camp 2013!

All areas marked * are required.

First Name *

Surname *

I prefer to be called *

Email Address *

Home Phone *

Cell Phone

Street Address *

Suburb

Town *

Postcode

I am *

Camps I have attended *

I have the following dietary requirements

Please check the boxes that apply

I will be attending the training weekend from 3-4 September 2011, OR

I would like to speak with someone about Camp before committing to the training weekend.

If selected, I am available for the whole duration of camp. (Tuesday 17 - Sunday 22 January 2012)

I will be at least 18 years old on 17 January 2012.

Any Queries/Further Information

If you have difficulties completing or submitting this form, please click here to let our web administrator know of the problem ~ thank you!

A Word About Privacy

Your privacy is very important to us. Any details you supply will be treated in strict confidence, and will not be distributed to any third party outside of our Camp Quality Wellington/Central Districts Administration without your permission.