Toddler Jam @ SDAC Registration form 2019
Form to register for Toddler Jam @ SDAC in 2019 (Please only use this form if you have attended a Toddler Jam @ SDAC and spoken to our team)
First name of carer bringing child *
Your answer
Surname of carer bringing child *
Your answer
Carer contact phone number *
Your answer
Carer email *
Your answer
Carer Suburb *
Your answer
First name of 1st child *
Your answer
Surname of 1st child *
Your answer
Date of birth of 1st child *
MM
/
DD
/
YYYY
Relationship of Carer to 1st child *
First name of 2nd child
Your answer
Surname of 2nd child
Your answer
Date of birth of 2nd child
MM
/
DD
/
YYYY
Relationship of Carer to 2nd child
First name of 3rd child
Your answer
Surname of 3rd child
Your answer
Date of birth of 3rd child
MM
/
DD
/
YYYY
Relationship of Carer to 3rd child
First name of 4th child
Your answer
Surname of 4th child
Your answer
Date of birth of 4th child
MM
/
DD
/
YYYY
Relationship of Carer to 4th child
Other important information
Please list any other information that we need to know about e.g. medical,allergies, special needs etc.
Your answer
Photography/Videography Waiver *
Children may be photographed or recorded on video during the course of Toddler Jam program/events. Please indicate below whether you give consent for the image of the child/ren you bring to Toddler Jam to be used in either print, electronic, or video form in internal media and/or external media ie. Facebook
I have read and understood the 'Welcome to Toddler Jam leaflet' *
Required
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