Kids Club Booking & Indemnity Form

1

Booking Name* This field is required. Name your reservation at the park is in

First Name

Last Name

2

Chalet or Site Number* This field is required. Please specify if a Site or Chalet when putting the number or letter

3

Email* This field is required.

example@example.com

4

Mobile Number* This field is required.Please enter a valid phone number

5

Child Names & Ages* This field is required.Separate names with commas

Eg: Max, John, Tilly Smith

Eg: 12, 7 & 5

6

Booking Dates* This field is required.Please write days & dates you would like to book your children into Kids Club (subject to availability)

7

Does your child have any allergies? (Food, environment, medical)* This field is required.

8

If yes, please enter below:

9

Does your child have a special diet?* This field is required.

10

If yes, please explain below:

11

Does your child (please tick):* This field is required.

Have a medical condition?

Take medications?

Nil

12

If yes, please explain below:

13

Do you give permission for Kids Club staff with Senior First Aid certificates to administer approved medication?* This field is required.

Yes

No

14

If no, what measures need to be in place?

Please advise

15

Is there anything else we should know about your child? (Custodial issues, behavioural etc - please specify):

16

I give permission for my child to be photographed?* This field is required.

Yes

No

17

I give consent for photographs to be used online for BIG4 Emu Beach?* This field is required.

Yes

No

18

I authorise the Kids Club Co-Ordinator or staff in charge of BIG4 Emu Beach Holiday Park Kids Club where it is impractical to communicate with me, to arrange for my child to receive such medical treatment as deemed necessary at the time during any Kids Club activities. I further authorise the use of Ambulance or professional medical care if deemed necessary. I fully accept responsibility for all payment associated with any such treatments required. I also appreciate that every care will be taken by staff and those connected with the Kids Club group cannot be held responsible for personal injury, loss or theft of property affecting my child.

By signing this document below you agree to the above statement and accept this booking with all terms & conditions clearly laid out.

19

Signature* This field is required.

Clear

20

Today's Date* This field is required.

Date