October 2021 Holiday Programme
Booking Form
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Email *
Child's Name: *
Child's Age: *
Child #2 Name and Age:
Child's #3 Name and Age:
Child #4 Name and Age:
Parent/Guardian's Name: *
Parent/Guardian's Email: *
Parent/Guardian's Phone Mobile Number and Emergency Contact details if different: *
Which programmes will be attended? (AM 10-12, PM 1.30-3.30, $10 per session) *
Are there any allergies, health or behavioural issues to be aware of?
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Name of Medical Centre child/ren enrolled in: *
I give my permission for my child/ren to be photographed (photos may be used for our Facebook page or marketing) *
Payment (Confirmation of booking will be sent upon payment received. No refunds will be given unless notice of cancellation is received 48 hours prior) *
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