Registration: Circus Holiday Club
Wednesday 9 - Friday 11 October, 9:30am - 12:30pm, Oxley Vale Public School
Basic information
Child's Name *
Your answer
School year *
Home address
Your answer
Parent/guardian's name *
Your answer
Contact number *
Your answer
Emergency contact (if parent uncontactable) *
Your answer
Emergency contact number *
Your answer
Health and safety
Please describe any allergies or medical conditions your child has that volunteer staff should be aware of (e.g. nut allergy, bird phobia, etc):
Your answer
Please describe any behaviour or social concerns your child has that volunteer staff should be aware of (e.g. aspergers, difficulty forming peer bonds, etc):
Your answer
Parental consent
"I give permission for my child to participate in all activities of the "Circus " Holiday Kids Club (hosted by volunteers from Oxley Vale Anglican Community Church) and I understand that photos/video may be used for promotion (unless I opt out; see below). In case of emergency I give permission for medical attention to commence until I or my emergency contact can be contacted. I agree that my child will follow instructions and directions given by leaders to ensure all children are safe and valued."

Cost is $2/day which covers craft resources, morning tea and miscellanies.
Opt-OUT of photo/video
Our photographer will make every effort to ensure children who cannot be publicly identified for legal reasons are not featured in digital recordings of the event. If this is true of your child or a child in your care, please make sure they also know that they should indicate so to the photographer.
Consent *
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