Allergy 250K Peer Mentor Workshop - Allergy & Anaphylaxis Australia

Thank you for expressing your interest in attending the Allergy 250K Peer Mentor Workshop in Sydney.

We’re really looking forward to bringing everyone together to connect, share ideas, reflect on experiences, and help shape the future of the Peer Mentor Program and Camps.

To help us organise travel, accommodation, catering and workshop logistics, please complete the questions below by no later than 12pm on Wednesday 21 October.

If you have any questions, please feel free to contact Tiffany Ma, Allergy 250K Project Lead at [email protected].

Workshop name:

Allergy 250K Peer Mentor Workshop

Date:

Saturday 5 December 2026

Location:

Sydney, NSW

Registration Form:

Name(Required)

First Last

Date of Birth(Required)

Phone(Required)

Email(Required)

Home Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Will you be attending the social activity after the workshop?(Required)

Yes

Emergency Contacts

Emergency Contact #1

Emergency Contact Name(Required)

Relationship to you(Required)

Phone number(Required)

Emergency Contact #2

Relationship to you(Required)

Emergency Contact Name(Required)

Phone number(Required)

Dietary and Medical Information

To assist with catering and accommodation planning:

Do you carry a prescribed adrenaline device?(Required)

Yes

If you have been prescribed two adrenaline devices, please remember to bring them with you, along with your current ASCIA Action Plan for Anaphylaxis. We encourage all attendees to keep their adrenaline devices with them throughout the workshop.

As an additional safety measure, general-use adrenaline devices will also be available during the workshop. However, these are not intended to replace your own prescribed device(s). Thank you for helping us create a safer and inclusive environment for everyone.

Do you have any food allergies?(Required)

Yes

If yes, please list your food allergies:(Required)

Please list any additional dietary requirements that we need to be aware of and any known triggers if this applies.(Required)

Examples: Eosinophillic Oesophagitis (EoE), food intolerance, coeliac disease, vegetarian, halal

Do you have any other allergic conditions?(Required)

Yes

If yes, please list what they are:(Required)

Examples: latex allergy, medication (drug) allergy, insect or tick allergy.

Do you have any other medical conditions that we should be aware about?(Required)

Yes

Examples, but not limited to: Asthma, diabetes, epilepsy

If so, please list what they are:(Required)

Do you have any accessibility, learning, sensory, communication, disability, or neurodiversity-related support needs that we should be aware of to support your participation in the workshop?(Required)

Yes

Prefer not to say

If yes, please provide details:(Required)

Travel Requirements

A&AA will be arranging travel and accommodation on your behalf.

To help us plan travel and accommodation arrangements, please answer the following questions.

Travel to Sydney

Will you be travelling from outside the Sydney metropolitan area to attend the workshop?(Required)

Yes

What state and suburb, town or city will you be travelling from?(Required)

City State / Province / Region

How do you expect to travel to/from Sydney?(Required)

Flight

Public transport (Train, metro, bus)

Other

Accommodation Requirements

To support peer mentors travelling from outside Sydney, accommodation may be provided where required for a maximum of two nights for people attending the workshop and social activity.

Will you require accommodation during the workshop?(Required)

Yes

Unsure

Shared Accommodation

To help us plan accommodation arrangements:

Would you be comfortable sharing a 1 bedroom serviced apartment that has two single beds with another peer mentor of the same gender where kitchen facilities are shared for sourcing and preparing your own food?(Required)

Yes

Maybe, depending on arrangements

If maybe, please specify:(Required)

Do you have any accommodation requirements or preferences that we should be aware of?(Required)

Yes

Examples may include accessibility requirements, medical needs, sleeping arrangements, cultural or religious considerations, or other factors that may affect accommodation arrangements.

If yes, please provide details:(Required)

Is there anything else you would like to tell us about accommodation/sharing requirements, for example who you would like to share with?

Privacy Collection Notice

Please refer to our Security & Privacy Policy for more information.

Consent to Collect, Use and Disclose Health Information

I consent to Allergy & Anaphylaxis Australia collecting, using and disclosing the participant’s health and other sensitive information where reasonably necessary to assess registration, plan supports, protect health and safety, administer medication, provide first aid, respond to emergencies, and deliver the workshop.

I understand the purposes and possible recipients described in the Privacy Collection Notice.
I understand I can withdraw optional consent, but this will not affect action already taken and may affect the organiser’s ability to safely support participation.
I authorise relevant safety information to be shared with personnel and service providers who need it for the participant’s care or workshop safety.

Please indicate your consent preference:(Required)

I consent to one or more of the options above

I do not consent

Please select all that apply(Required)

I understand the purposes and possible recipients described in the Privacy Collection Notice.

I understand I can withdraw optional consent, but this will not affect action already taken and may affect the organiser’s ability to safely support participation.

I authorise relevant safety information to be shared with personnel and service providers who need it for the participant’s care or workshop safety.

Photography and Media Consent

Please indicate which of the following you consent to:(Required)

I consent to optional use of my photographs or videos specified in my selection below.

I do not consent to any optional use of my photographs or videos.

Please indicate which of the following you consent to (select all that apply)(Required)

Photos/videos being used in Allergy & Anaphylaxis Australia (A&AA) internal reports and presentations.

Photos/videos being used in A&AA newsletters and communications.

Photos/videos being used on the A&AA website.

Photos/videos being used on A&AA social media.

Participant Declaration

I confirm that the information provided in this registration form is accurate and complete to the best of my knowledge.
I agree to notify Allergy & Anaphylaxis Australia if my travel arrangements, accommodation requirements, emergency contact information, dietary requirements, allergies, medical information, or support needs change before the workshop.
I understand that the information collected in this form will be used to organise travel, accommodation, catering and support arrangements for the Peer Mentor Workshop.
I understand that I am responsible for managing my own allergy and anaphylaxis risks outside of workshop activities. Allergy & Anaphylaxis Australia will take reasonable steps to manage allergy-related risks during the workshop and catered workshop activities.
I understand that I am responsible for bringing any prescribed medications, including adrenaline devices and other required medications, to the workshop and during my stay. I understand I can also bring food for myself to eat to the workshop and to my accommodation.
I agree to carry my prescribed adrenaline device and any other required medications with me at all times during the workshop and during my stay.
I agree to follow all safety instructions and risk management procedures provided by Allergy & Anaphylaxis Australia, venue staff, and accommodation staff.
I agree not to share food, drinks, medications, or eating utensils with other participants.
I agree to immediately report any allergic reactions, symptoms, medical concerns, lost medication, or potential allergy-related incidents to nominated Allergy & Anaphylaxis Australia staff.
I acknowledge that while Allergy & Anaphylaxis Australia will take reasonable steps to support allergy management, I remain responsible for managing my own medical condition and following my ASCIA Action Plan (where applicable).
I consent to the use of AI-assisted transcription and note-taking tools during the workshop to help capture discussions, feedback and action items. I understand that the information collected will be used for workshop planning, evaluation and future program development and will be managed in accordance with applicable privacy requirements.

Please indicate your consent to the statements above.(Required)

I consent and agree to all of the statements outlined above.

I do not consent or agree to one or more of the statements outlined above and understand that this may affect my ability to participate in the Peer Mentor Workshop.

By submitting this form you are also consenting to receive communication from Allergy & Anaphylaxis Australia. Including:

Allergy News and Updates
Upcoming Events
Research and Survey Opportunities
Get Involved

There will be opportunity to update these preferences.

Thank you for registering for the Allergy 250K Peer Mentor Workshop in Sydney. We will review your registration and contact you if further information is required regarding travel, accommodation, catering or support arrangements.