Kids' Club and Junior Youth Registration
To be completed by parent/guardian wishing to register their child/ren for Kids Club or Junior Youth. Cost is $2/week and covers admission, supper and activities. Eftpos is available.

Parent/Guardian Details

Please list someone different to the Parent/Guardian above.
Please note, transport assistance is only provided where a caregiver is for some reason unable to fulfil this parenting commitment.

Family Details

Participant 1 Details

Please include severity of allergy/medical condition and include treatment.

Participant Two Details

Please include severity of allergy/medical condition and include treatment.

Participant Three Details

Please include severity of allergy/medical condition and include treatment.

Still More?

List name, date of birth, gender, medicare no. & allergies for each.

Agreement

To be completed by Parent/Guardian or Participants 18+ years old
Eg. inclusion on our Facebook page, website or a flyer.
Field to be completed only by Guardian or Participant 18+ years old. To view our Privacy Policy, please visit the 'About Us' section of our website.