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Parental Contact Details

Your Title:

First Name:

Last Name:

Address:

Suburb:

State:

Postcode:

Contact Number :

Email:

Details for Child

Child's First Name:

Child's Last Name:

Child's Gender:

Child's Date of Birth:

Child's School:

Medical Conditions:

Emergency Contact Person:

Relationship to Child:

Emergency Contact Number:

Camp Specific Details

Camp you wish to enroll the child in:

Friends they wish to participate in the camp with:

Details for Child 2

Child's First Name:

Child's Last Name:

Child's Gender:

Child's Date of Birth:

Child's School:

Medical Conditions:

Emergency Contact Person:

Relationship to Child:

Emergency Contact Number:

Camp Specific Details for 2nd child

Camp you wish to enroll the child in:

Friends they wish to participate in the camp with:

Details for Child 3

Child's First Name:

Child's Last Name:

Child's Gender:

Child's Date of Birth:

Child's School:

Medical Conditions:

Emergency Contact Person:

Relationship to Child:

Emergency Contact Number:

Camp Specific Details for 3rd child

Camp you wish to enroll the child in:

Friends they wish to participate in the camp with:

Details for Child 4

Child's First Name:

Child's Last Name:

Child's Gender:

Child's Date of Birth:

Child's School:

Medical Conditions:

Emergency Contact Person:

Relationship to Child:

Emergency Contact Number:

Camp Specific Details for 4th child

Camp you wish to enroll the child in:

Friends they wish to participate in the camp with:

Details for Child 5

Child's First Name:

Child's Last Name:

Child's Gender:

Child's Date of Birth:

Child's School:

Medical Conditions:

Emergency Contact Person:

Relationship to Child:

Emergency Contact Number:

Camp Specific Details for 5th child

Camp you wish to enroll the child in:

Friends they wish to participate in the camp with:

Payment Details.

When would you like to pay?

Do you have a discount voucher?


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