Holiday Club 2020 - Registration Form 28-09-19 to 2-10-19
Child's Full Name: *
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School Grade *
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Parent/Guardian's Full Name: *
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Home Address: *
Please include House Number, Street, Suburb and Postcode.
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Parent/Guardian's Contact Phone Number: *
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Parent/Guardian's Emergency Contact Phone Number: *
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Name of authorised person who will pick up your child. *
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Allergies or Prohibited Foods:
Please provide full details.
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Medications:
Please provide full details.
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May your child's photo be taken? Please select your preferences below. *
Please indicate days your child would attend *
Required
If you would like to be notified about future Holiday club events at CHBC please insert your email address below
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