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Cnr Orchard Rd
& Albert Ave,
Chatswood
ph 9419-3179

Holiday Kids Club

Registration Form

Please note that by registering you are giving consent for your child/children to attend, and understand that while everything will be done to ensure your child's safety, we take no responsibility for any accident or illness that may occur, howsoever caused.

Fields marked in Red are Mandatory

Last Name:
Parents Name:
Child 1:	Name of child 1 Age School Year Days Attending (please ticks) Select 56789101112 Select K123456 Wed 13th Thu 14th Fri 15th
Child 2:	Name of child 2 Age School Year Days Attending (please ticks) Select 56789101112 Select K123456 Wed 13th Thu 14th Fri 15th
Child 3:	Name of child 3 Age School Year Days Attending (please ticks) Select 56789101112 Select K123456 Wed 13th Thu 14th Fri 15th
Child 4:	Name of child 4 Age School Year Days Attending (please ticks) Select 56789101112 Select K123456 Wed 13th Thu 14th Fri 15th
Contact Number:
E-mail Address:
Address:
Allergies:
Medical Conditions:
Extra Comments:
	I hereby give consent for my child / children to attend, and understand that while everything will be done to ensure their safety, we can take no responsibility for any accident or illness that may occur, howsoever caused. I also give consent for my child / children to be photographed for promoting holiday Kids Club. I agree (please tick) All information submitted will be considered as confidential. If you have futher questions, or wish to change your registration, please contact us.

Please come with your child at 9.15am on your first day to enrol and pay. All children need to be signed in and out by an adult.