Register for Holiday Kids Club April 2024
Holiday Kids Club: Thurs 18 April 2024

131 Gunnedah Road, Taminda, Tamworth NSW
Contact us: Esther Hutton 0490 164 751   |   Sam Blaxland 0491 119 982

Sponsored by Tamworth Bible Baptist Church
Free Entry | Ages 6-13
Sign in to Google to save your progress. Learn more
Child's information
First and last name *
Gender *
Date of birth *
How did you first hear about HKC? *
Required
Child's medical details
Does the child suffer from (please tick) *
Required
If you have ticked any of the medical conditions listed, please provide further information regarding the condition and the administration of any medication in the space provided.
(eg. Asthma - 2 puffs of Bricanyl to be taken at 9 am) Please note: Scheduled medication must be provided in the original container (as required by legislation).
Medicare number *
Position on card *
Valid until *
Date
Child's dietary information
If your child has special dietary requirements, please provide the necessary information in the space provided.
Enrol a second child?
Clear selection
Next
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy