Kids Club Gingerbread Afternoon 2017
Friday 8th December 4:30 PM - 6 PM
Nowra Baptist Church: 194 Old Southern Road, South Nowra
Contact us at (02) 4423 6978 or office@nowrabaptist.org.au
Email address *
Child's First Name *
Your answer
Child's Surname *
Your answer
Date of Birth: *
MM
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DD
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YYYY
School: *
Your answer
School Year *
Address *
Your answer
Parent’s Contact Details
Mother’s/ Guardian’s Name: *
Your answer
Mother’s/ Guardian’s Mobile: *
Your answer
Father’s /Guardian’s Name: *
Your answer
Father’s /Guardian’s Mobile: *
Your answer
Other Emergency Contact Name *
Your answer
Other Emergency Contact Number *
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Medical Information
Medicare Number: *
Your answer
Health Fund:
Your answer
Please detail any medication your child is on: *
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Please detail any special dietary requirements your child has: *
Your answer
Please detail any allergies or other special needs: *
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Please name other children you will know at Kid’s club if any. *
Your answer
Do you attend a church? *
Church Name
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How did you find out about us? *
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