Registration Form: Kids Holiday Club

A holiday program for children in Kindy through to Year 6 at Rouse Hill Anglican Church

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    Child 1

    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question

    Child 2

    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question

    Child 3

    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question
    This is a required question

    Parent/Carer Details

    This is a required question
    This is a required question
    This is a required question
    This is a required question

    What adults can sign your child in and out?

    Under our duty of care, we will only allow your child to be signed in or out by the parent/carer named above. If you would like another person who is 18 years or older to sign your child in or out, please provide their name(s) below.
    This is a required question

    Emergency Contact Details

    This needs to be someone other than the parent/carer named above that we can contact in an emergency should we be unable to first contact the parent/carer.
    This is a required question
    This is a required question