Value - $750 19 - 23 April 2021 04 - 06 October 2021 (details TBC) - the Future Champions Trust
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19 – 23 April 2021
04 – 06 October 2021 (details TBC)
Value - $750
In light of Covid-19 and lack of opportunities for International Travel, the Future Champions Trust is
providing other opportunities to provide life and leadership skills for our high achieving sporting
youth. Please tell us in 150 words, below, what you would gain from this opportunity.
New Zealand Blue Light
www.bluelight.co.nz – programmes@bluelight.co.nz
PREFACE
Thank you for enquiring about the upcoming New Zealand Blue Light Leadership Voyages. Attached is
some information that will assist you in ensuring they are well prepared for the voyage. The Voyages are
designed to focus on giving young people the opportunity to experience life on the water. The camp will
focus on developing leadership skills, sailing skills, environmental learning, and teamwork. Please note the
details for the October sailing are yet to be confirmed.
Camp Activities and Consent Forms
Included in these joining instructions are the below information:
• Blue Light Consent Form, NZ Sail Medical and Consent form (These need to be filled in and sent
back ASAP tyra@bluelight.co.nz)
• Gear List
• Drop off and Pick Up Instructions
The purpose of these forms is to ensure that the successful applicant has all the vital information required
to be adequately prepared for the voyage.
NOTES:
• ALL PARTICIPANTS ARE ADVISED NO MONEY IS NEEDED ON THE VOYAGE.
• ALL ITEMS MUST BE NAMED.
• ALL BLUE LIGHT VOYAGES ARE TOTALLY ALCOHOL AND SMOKE FREE
New Zealand Blue Light
www.bluelight.co.nz – programmes@bluelight.co.nzStart Date – Monday 19 April 2021, October details TBC
Departure Time – 12pm
Where To Meet – Meet at the Explore Kiosk, 220 Quay Street, Eastern Viaduct. (Please have
lunch before you arrive)
End Date – Friday 23 April 2021
Arrival Time – 10am
Where To Meet – Meet at the Explore Kiosk, 220 Quay Street, Eastern Viaduct.
Sickness or Unable to Attend on the Day
If a participant is sick on the day of the activity it is best for them not to attend to stop illness from
spreading. Inform the emergency contact if a young person will not be attending.
Emergency Contact: Tyra – 021 287 4563
Camp Coordinator
New Zealand Blue Light
www.bluelight.co.nz – programmes@bluelight.co.nzDROP OFF & PICK UP INSTRUCTIONS:
• If you are dropping off and/or picking up the child you can park in the
Downtown Carpark, 31 Customs St West and then walk to the marina.
However, there is some street parking around Market Place.
New Zealand Blue Light
www.bluelight.co.nz – programmes@bluelight.co.nzGEAR LIST
Over the course of your sailing journey you may well encounter weather conditions far beyond anything you will experience in
the city. You must have the suitable clothing and equipment.
Please ensure that you obtain all of the gear outlined on the list below, please stick to this list and don’t bring too much as there
is limited space downstairs for gear.
GEAR REQUIRED 2-3 day 4-5day PACKED
Soft Gear Bag (you must be able to fit all of the required gear below into it)
Sleeping Bag
Pillow (you can use a jumper instead)
Small Daypack (backpack)
Water Bottle
Sandshoes / Running shoes (clean ones for on deck, non-marking if possible) 1 2
Jandal’s 1 1
Plastic Bags (for wet clothes stowage in your bag) 4 4
Waterproof Jacket and Pants (GORETEX or REFLEX is preferred) 1 1
Fleece 1 1
Polypropylene/wool/fleece base layer 2-3 4
Polypropylene/wool/fleece long johns 1 2
Socks 2-3 4
FOR WINTER SAILING
Socks (preferably woollen or thick socks) 2 2
Gloves (one pair of fleece/polypro pair) 1 1
Woollen/Fleece Beanie and/or Balaclava 1 1
T-shirts (preferably ‘dri-fit’ style, no cotton please as it doesn’t dry) 2 4
Shorts 2 3
Togs 1 1
Track pants 1 1-2
Personal underwear 3-4 5-6
Towels 1 2
Sunhat 1 1
Sun Glasses
Torch/Batteries (with extra batteries) (Head torch is preferable)
Sun Screen/Lip Balm
Personal Toiletries (soap, toothbrush and paste, deodorant, no spray deodorant or spray
sunscreen please, no wet wipes please etc.)
Any Personal Medication
Simple first aid kit (band aids, aspirin/Panadol, etc.)
(The Vessels have comprehensive kits available)
Sea Sickness Tablets (it is advised that you buy some sea sickness medication if you are unsure
whether you get sea sick or not), take these 2hrs prior and let the crew know you have taken them
Please note:
• Denim jeans, cotton t-shirts and casual shoes are totally unsuitable for the conditions we will be encountering in the Hauraki
Gulf. When they get wet they don’t dry and are cold.
• i-pods, mobile phones and cameras on board, you are welcome to bring these along and there are opportunities for photos
and videos to be made during the journey. We would recommend a dry pouch or sealable plastic bag to protect them from
the elements and the safety of these devices will be your responsibility.
You MUST have all of the above equipment to be prepared for your journey. The preference should be to borrow any gear from
the above list that you do not personally own.
Most importantly, all of the above gear must fit into one soft bag as space is limited down stairs.
New Zealand Blue Light
www.bluelight.co.nz – programmes@bluelight.co.nzNew Zealand Blue Light
Leadership Voyages: 19 – 23 April + 04 – 08 October 2021
CONSENT FORM
I,_________________________as parent/caregiver of_____________________________
Give consent for him/her to take part in the Blue Light Leadership Voyage being run on board the Steinlager 2 Boat,
Auckland 19 – 23 April 2021.
I acknowledge that risk of injuries is inherent in physical activities. While I am aware that staff will take all due
care, I recognise that accidents may occur.
The staff and supervisors have my authority to take whatever action they think necessary to ensure the safety, well
being and successful conduct of the participants as a group or individually in the above-mentioned activity.
If my child becomes ill or is accidentally injured, Blue Light may obtain on my behalf whatever medical treatment my
child requires at my expense.
I have attached additional health information relevant to my child.
I acknowledge that Blue Light and the NZ Police accept no liability for any personal injury or property loss suffered by
my child during the event.
New Zealand Blue Light regularly produces materials to profile its various programs and services to the community.
Blue Light reserves the right to use these materials which include media releases and publications. At times these
materials contain stories and photos of clients.
Signed: Parent / Caregiver
Date:
Note: All medical details have been submitted to NZ Blue Light on the Sail NZ Medical form and consent.
Please write down the following contact number of event coordinator in case you need to contact your child -
Tyra Land – 021 2874563
PARENT CONSENT FORM
New Zealand Blue Light
www.bluelight.co.nz – programmes@bluelight.co.nzPlease tick the box below to indicate your preferred sailing:
NZ Blue Light Leadership Voyage 19 – 23 April 2021
NZ Blue Light Leadership Voyage 04 – 08 October 2021
PARTICIPANT INFORMATION FORM
Please complete these details:
Name Student
Address
Email:
Telephone (home) (mobile)
Gender: M / F
Student age:
Student Ethnicity D.O.B:
Family Doctor Name Dr Phone Number
Doctor’s Address
EMERGENCY CONTACT DETAILS (please provide at least 2 sets of contact details)
Contact 1: Emergency Contact
Name: Relationship:
Address:
Phone: Mobile:
Email:
Contact 2: Alternative contact
Name: Relationship:
Address:
Phone: Mobile :
Email:
New Zealand Blue Light
www.bluelight.co.nz – programmes@bluelight.co.nzTo be read and signed by the adult assistant or parent/caregiver of the student participant.
Parental Consent
I agree to my son/daughter taking part in a New Zealand Sailing Trust programme. I agree to his/her participation in the activities
described. I acknowledge the need for him/her to behave responsibly.
I agree that my sons/daughters written evaluation of the journey, group stories, videos or photographs may be used in publications
associated with the NZ Sailing Trust. Publications may include Trust newsletters, annual reports, websites, Facebook and in the
media.
Acknowledgement of Risk
I understand that there are risks associated with any involvement in a school EOTC event and that these risks cannot be completely
eliminated. I understand that the NZ Sailing Trust and the school will identify any foreseeable risks or hazards and implement
correct management procedures to eliminate, isolate or minimise those hazards. I understand my son/daughter will be briefed with
these safety procedures on boarding the vessel. I will do my best to ensure that my son/daughter follows these procedures.
I know that I am able to ask any questions of the NZ Sailing Trust or the school about the activities my son/daughter will be involved
in to gain a better understanding of the risks involved. I recognise that participation in such activities is voluntary and not mandatory
through a ‘challenge by choice’ procedure. My son/daughter and I both understand that they may withdraw from an activity if he/she
feels at risk. This must be done in consultation with the person in charge.
I understand that the NZ Sailing Trust or the school does not accept responsibility for loss or damage to personal property and that
it is my responsibility to check my own insurance policy.
Parent Name:
Parent Signature:
Date:
New Zealand Blue Light
www.bluelight.co.nz – programmes@bluelight.co.nzMEDICAL INFORMATION AND CONSENT FORM
The information on this form will, in general, remain confidential to the teachers/instructions in charge of/or assisting with this trip. However, in the interests of
the safety of all involved, any life threatening conditions may have to be made known to other students.
Please be assured that your son/daughter’s physical and emotional well-being remains of paramount importance to us at all times.
Son/daughter’s Does he/she wear a Medic Alert
Name bracelet – if so what is the
number & where is it worn
1. Please tick if your son/daughter has any of the following medical conditions:
Migraine Epilepsy Asthma
Diabetes Travel sickness Fits of any type
Chronic nose bleeds Heart condition Dizzy spells
Colour blindness Anaphylaxis
Any other medical
conditions (Please
specify)
As your son/daughter will be rooming with other students, please provide information on any relevant issues:
Sleepwalking Snoring Sleep Apnoea
2. Is your son/daughter currently taking medication? Yes No
If YES, please state ailment/s,
name of drug and dose:
3. Has your son/daughter had any major injuries (breaks or strains) or illness (glandular fever etc.) in the last six months that
may limit full participation in any activities?
4. When was your /your child’s last tetanus
injection?
5. Is your son/daughter allergic to any of the following?
Yes No Please specify and treatment required
Prescription medication
Food
Insect bites/stings
Other allergies
New Zealand Blue Light
www.bluelight.co.nz – programmes@bluelight.co.nz6. Please outline any other dietary requirements:
_____________________________________________________________________________________________________________________
_____________________________________________________________________________________________________________________
7. Please tick the box if you are happy for your son/daughter to be administered antihistamines in the case of any allergies: ☐
8. What pain/flu medication may your son/daughter be given if necessary? ____________________________________________
9. Please circle if you are happy for your son/daughter to be given a sea legs tablet if they get seasick? Yes No
10. To the best of your knowledge, has your son/daughter been in contact with any
contagious or infectious diseases in the last four weeks? Yes No
If YES, please provide information
11. Is there any information the staff should know to ensure the physical and emotional safety of you/your child? (For example cultural
practices, disability, and anxiety about heights/darkness/small spaces, pregnancy, behaviour or emotional problems).
☐ Yes ☐ No
If YES, please state or attach the
information.
New Zealand Blue Light
www.bluelight.co.nz – programmes@bluelight.co.nzMEDICAL CONSENT
I certify I am the legal Guardian of (name of student)
Where it is impractical to contact me, I authorise the teacher/instructors in charge of the programme to consent to the child receiving such medical or surgical
treatment as may be deemed necessary.
TICK
I agree that if prescribed medication needs to be administered, a designated adult will be assigned to do this. I will ensure that
prescribed medication is clearly labelled, securely fastened and handed to the designated adult with instructions on its administration.
I will inform the school/Trust as soon as possible of any changes in the medical or other circumstances between now and the
commencement of the event.
I agree to my child/myself receiving any emergency medical, dental, or surgical treatment, including anesthetic or blood
transfusion, as considered necessary by the medical authorities present.
Any medical costs not covered by ACC or a community service card will be paid by me.
If my son/daughter is involved in a serious disciplinary problem, including the use of illegal substances and/or alcohol, or
actions that threaten the safety of others, s/he will be sent home at my expense.
Swimming Ability Information
Yes No
Are you able to swim 50 metres?
Are you confident in deep water?
Are you able to tread water?
Are you able to survival float?
To be read and signed by the parent/guardian of student participant.
Parent’s Name
Signed Date
New Zealand Blue Light
www.bluelight.co.nz – programmes@bluelight.co.nzSUPPORT NZ SAILING TRUST
I would be interested in purchasing merchandise for my son/daughter: Please tick
☐ Lion NZ available in Grey Marl colour and sizes Small to XX Large, only a short sleeve style available $29.95
☐ Steinlager 2 available in Charcoal colour, sizes Small to XX Large, both long sleeve $38.00 and short sleeve $29.95 styles
Short Sl $29.95 Qty _____ Size _______ Long Sl $38.00 Qty______ Size________ $25.00 Quantity _
Merchandise is to be paid 1 week prior to departure. Please indicate how you wish to pay.
☐ Pay by invoice. Please provide email to send invoice ______________________________________________________________
☐ Pay by credit card. ☐ I authorise NZ Sailing Trust to charge the agreed amount listed below to my credit card provided herein. I
understand that my information will not be saved or shared with any other parties.
Credit Card Information
Type of card: Visa/Mastercard Amount to be charged: $
Cardholder Name (as shown on card):
Card Number: _ _ _ _ / _ _ _ _ / _ _ _ _ / _ _ _ _
Expiration Date (mm/yy): _ _ / _ _ Security Number (3 digits on back of card): _ _ _
Amount to be charged:
Signature Date
On receipt of full payment, the paid merchandise will be on board for your son/daughter.
New Zealand Blue Light
www.bluelight.co.nz – programmes@bluelight.co.nzYou can also read
