Cars Holiday Programme Registration Form
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Child's first name: *
Child's last name: *
Child's age:
Children aged 5-11 may attend the programme. 5-year-olds must have been at school for at least a term to attend.
 *
Parent/caregiver's first name: *
Parent/caregiver's last name: *
Parent/caregiver's phone number: *
Parent/caregiver's email: *
Does your child have any dietary requirements, allergies or intolerances? Please specify:
Does your child have any health conditions, behavioural conditions or neurodiversities you would like us to be aware of?
Will your child be bringing any medication to the holiday programme? Please specify:
Which day/s will your child be attending?
Time: 8:30am-3:30pm
 *
Required
Is your child doing any half days? Please specify which days, and whether morning/afternoon:
Pick up/drop off can happen anytime in the 12:00-12:30pm lunch period.
Emergency contact first name: *
Emergency contact last name: *
Emergency contact phone number: *
I give permission for any photos or videos taken at the holiday programme that feature my child to be used for promotional purposes by St Margaret's Church. *
I give permission for holiday programme leaders to provide or seek first aid for my child if required. *
Have you paid your child's fees ($10/day)?
Your child's place in the holiday programme will be confirmed via email once we receive payment.
(If cost is a barrier to attending, please select the second option and we will be in touch.)

Bank account name: St Margaret's Anglican Church
Bank account number: 38-9001-0513335-01
Code: HPOCT
Reference: [Your child's name]
 *
Any other comments?
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