Holiday Kids Club
First Name
Last Name
Gender
Male
Female
Date of Birth
Email Address
Mobile Number
Home Address
School Grade
-- None --
Nursery/Pre-school
Kindergarten
1
2
3
4
5
6
7
8
9
10
11
12
Special Needs Child
Yes
No
Are there things we should know about your child? (eg: allergies, disability, restricted people, etc)
Emergency contact - Name and number (in the event of being unsuccessful with the above information)
Days Attending
Wednesday 5th
Thursday 6th
Friday 7th
Submit