Registration

To register in the Youth leadership program, please complete the Program registration form below. To register in one of our events, please also complete the event form below and make your payment.

If you are new to the Viskam program, please register in both the program and the upcoming event that your child would like to participate in.

If your child is an existing participant, please skip the Viskam Program registration and only complete the upcoming event registration.

Have you registered in the Viskam Youth Leadership Program before?

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Viskam Youth Leadership Program Registration

First Name *

Last Name *

Date of birth

Grade/Year *

Gender *

Special requirements, if any

Parent/Guardian First Name *

Parent/Guardian Last Name *

Street Address *

Suburb *

Postcode *

Email: *

Phone: *

Emergency Contact Name

Emergency Contact Number

Parent’s Willingness to Participate as a Volunteer

Parent/Guardian’s Consent

I have read and agree to the Terms and Conditions and Program Waiver

Parent/Guardian Name *

Date of Consent *

Upcoming Event Registration

Participant First Name *

Participant Last Name *

Select an Event *

Parent/Guardian Name *

Email *

Date of Consent *

Program Registration Fee:

$60 (Includes Viskam T-Shirt & a Cap)

Event Fees (per participant):

Leadership activity day: $25
Youth Leadership camp: $120
Viskam Kit (Cap & T-shirt): $48

Other Fees/prices:

Youth Leadership camp - accommodation fee for a family of four: $496
Youth Leadership camp - accommodation fee per additional person: $78
Viskam cap for child/adult: $18
Viskam T-shirt child/adult: $30
Note: Accommodation fee excludes food costs (BYO)

Please make your payment to the following account:

Name: Viskam Australia
BSB: 062692
Account Number: 46781259
Reference: Participant name

Kindly email us at admin@viskam.com.au with receipt of your payment. We will confirm your registration shortly.

Thank you for participating in the Viskam Youth Leadership Program.

Viskam Youth Leadership Program Registration

Parent/Guardian’s Consent

Upcoming Event Registration

Youth Leadership – An Overview