Junior ranger registration form

Required fields are marked with an asterisk (*).

Region and schedule details

Choose region and day *

Katherine - every Tuesday

Choose term *

Term 3

Child details

Full name *

Date of birth *

Has this child been a junior ranger before? *

Is there any medical information or action plans we need to know about? * This includes allergies, medical conditions or medication your child may need to take regularly.
This helps us plan activities to be fun and inclusive. If yes, we may request additional information from you.

Guardian details

Guardian 1 - Full name *

Phone *

Email address *

Postal address *

Guardian 2 - Full name

Phone

Email address

Postal address

Choose an emergency contact *

Guardian 1
Guardian 2

Declaration

Code of conduct and talent release * We require a code of conduct and talent release form to be completed for all children in the junior ranger program. You will get these forms if your child is offered a placement in the program.

I agree to complete a code of conduct and talent release form

Privacy statement

The Department of Environment, Parks and Water Security (DEPWS) is committed to safeguarding the confidentiality and privacy of the information that it manages, uses and discloses in accordance with the Information Privacy Principles (IPP) in the Northern Territory Information Act 2002, and where applicable, with the Australian Privacy Principles (APP) in the Commonwealth Privacy Act 1988.

To contact us with a privacy question, or if you need more information about our privacy policy, you can write to us at PO Box 496, Palmerston, NT 0831, or call the DEPWS Privacy Officer on 08 8999 4410 business days, 8am to 4:21pm.

Last updated: 21 March 2024

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