Vacation Care Booking Form (18 - 29 September)
Please return by September 8th to avoid additional cost.
Please fill out a form for each child you would like to enrol.
Visit our website for the program and Terms and Conditions: https://www.northside.qld.edu.au/outside-school-hours-care
Email address
Application Date
MM
/
DD
/
YYYY
Student's Family Name
Your answer
Student's Given Name
Your answer
Student's Date of Birth
Your answer
Male/Female
Student's Centrelink CRN Number
Your answer
Class
Your answer
Teacher's Name
Your answer
Does your child have any allergies?
Your answer
Is there anything else we should be aware of?
Your answer
WEEK 1 (18 September - 22 September) Please indicate which days you will require:
I will require 7:30 am start for the following days during WEEK 1 (18 September - 22 September) for additional $5:
WEEK 2 Vacation Care (25 September - 29 September)
I will require 7:30 am start for the following days during WEEK 2 (25 September - 29 September) for additional $5:
Signed by:
Select one
Required
I/We accept the conditions of enrolment as set out above and hereby make application for our child to be enrolled in the Northside Christian College Vacation Care program.
Please type your name
Your answer
I authorise staff members of Northside Christian College Vacation Care to provide and arrange appropriate medical care and attention for the child in an emergency.
Required
I agree to Northside Christian College Vacation Care conditions of enrolment and fees
Required
I understand that checking this box constitutes a legal signature confirming that I acknowledge and agree to the above Terms of Acceptance.
Required
Date
MM
/
DD
/
YYYY
Date
MM
/
DD
/
YYYY
Please complete the captcha before submitting the form.
Submit
Never submit passwords through Google Forms.
This form was created inside of Northside Christian College. Report Abuse - Terms of Service - Additional Terms