AC4 – Adventurous Journey (AJ) Notification
This form is MANDATORY. All fields must be completed.
Please email a clear scan/copy of the completed form to the Queensland Award Operating Authority (AOA) via qld.award.office@qed.qld.gov.au at least TWO WEEKS prior to the journey start date.
AWARD CENTRE DETAILS
Award Centre name			
Award Leader name			Phone		
AJ Emergency contact name			NB. Emergency contact cannot be on the AJ and needs to be easily reached in case of emergency.	
AJ Emergency contact details	Mobile		Other		

AJ SUPERVISION
All journeys must have an AJ Supervisor OR an External Contractor/Commercial Operator as per AOA – Adventurous Journey Supervision Policy.
AJ Supervisor (AJS) name		Role		
Contact numbers	Mobile		Other		
OR
External Contractor business		Instructor name		
Contact numbers	Mobile		Other		

MANDATORY REQUIREMENTS
Award Leader has confirmed that AJS has appropriate level of currency to lead this type of journey in this location.		
Award Leader has confirmed external contractor has the appropriate qualifications for this journey, in line with AJ Policy. https://www.qld.gov.au/ data/assets/pdf_file/0019/51814/adventurous-journey-policy.pdf		
P4 AJ Parental Consent forms completed for each participant, and collected by Award Leader.
Participant cannot attend until their form has been submitted.		
Have all volunteers on this AJ met the Working with Children Check requirements? (Blue card is linked to Award Centre).
Volunteer cannot attend unless this has been met.		

APPLICATION FOR SHORTENED DURATION
If yes, you must provide full names of the participants and details of the competence and/or previous Qualifying Journey to the Qld AOA.
Are you applying for demonstrated competence outside the Duke of Ed?
The Practice Journey must be at minimum: 1 day (6-7 hours) Bronze and Silver level; 1 day (8 hours) and 1 night for the Gold level.		
Are you waiving the Practice Journey?
Silver and Gold participants can have their Practice Journey waived at the next level where a Qualifying Journey has been previously completed for a similar mode of travel and a similar type of AJ by largely the same group. This needs to be done in consultation with the Award Leader and the Award Centre’s AJ Assessor.		

ELECTRONIC COMMUNICATION DEVICES
Are you going to a remote location on this AJ?
If yes, you must take a Personal Locator Beacon (PLB) and appropriate communication equipment.		
Please refer to the section on Communication Equipment in the Queensland AOA - Adventurous Journey Supervision Policy. When planning your journey please consider the following two-way communication equipment: UHF radios, mobile phones and satellite phones.

ADVENTUROUS JOURNEY DETAILS
Start date		End date		Award Level/s		
Number of Award participants		Total number of young people on journey		Number of volunteers
(incl.AJS / External contractor)		Ratios are not to exceed one volunteer to every seven young people	

Type of Journey		Adventurous Journey	
Journey component		Preparation & Training	
		Virtual Adventurous Journey - requires prior AOA approval			Practice Journey	
		Adventurous Project - requires prior AOA approval			Qualifying Journey	
Back-to-back AJ		Are Participant/s completing both Practice & Qualifying sections on one journey?	

Mode of travel / journey activity / study
e.g. Outdoor medium, architecture, history, cultural & ethnic diversity		
Journey location, specific route / tracks, proposed study	DAY 1			Map name/s and number/s
(if not attached)	
	DAY 2				
	DAY 3				
	DAY 4				

Other comments or relevant information to assist AOA or emergency contact person to have a clear understanding of the journey	
(e.g. How you will manage multi-level groups / back-to-back / joint journeys with another Award Centre . Any further route or journey info etc.)	
ADVENTUROUS JOURNEY AUTHORISATION
AJ Supervisor
OR
External contractor endorsement	Name		
	Signature		Date		
I confirm the journey details listed on the form are correct, and I have the appropriate qualifications/currency in the medium/s to lead the journey in the area listed.

Award Leader authorisation	Name		
	Signature		Date		
I confirm the journey meets Award requirements, and the person leading the journeyhas the appropriate qualifications/currency in the medium/s to lead the journey in the area listed.

OFFICE USE ONLY	Notification received date		
YOUR PRIVACY
The Department of Education is collecting the personal information you provide to facilitate your involvement in the Award program. This will include the personal information that you submit via the Online Record Book Participant Registration Form. Your personal information will only be accessed by authorised officers who may provide the information to Award volunteers and organisations associated with the Award program to facilitate the Award program and to update and maintain records. Such as mail outs regarding award program information, award presentations and the alumni. Non-identifying statistical information may also be supplied to the National Award Operator, a non-government organisation that oversees the Award program In Australia. Your personal information will not be used for any other purpose or disclosed to any other party unless we have your consent or it is required by law. Your personal information is collected and managed in accordance with the Privacy Principles described in the Schedule 3 of the Information Privacy Act 2009 and, if applicable, in accordance with section 426 of the Education (General Provisions) Act 2006. You can access your own personal information by contacting the Queensland Award Operating Authority.
By completing this form I give my consent for the Department of Education to collect and store my personal information which may be used for the purposes outlined above.	
BLUE CARD
Under the Working with Children (Risk Management and Screening) Act 2000 people working with children under 18 years of age in certain categories of business or employment must undergo the Working with Children Check. The Working with Children Check (blue card system) applies to employees or volunteers associated with The Duke of Edinburgh’s International Award and Bridge Award programs. Employers and businesses providing regulated child-related services are also required to have a child and youth risk management strategy in place to protect children and young people from harm. For more information on whether you are required to hold a blue card or develop and implement a child and youth risk management strategy, please visit the Blue Card Services website at www.qld.gov.au/bluecard or call Blue Card Services on 1800 113 611
(free call). You can also read the fact sheet for The Duke of Edinburgh’s International Award at https://www.publications.qld.gov.au/dataset/blue-card-system- changes/resource/5963ee66-8a39-4aac-aa1c-2e9368da0f6f .