PAYMENT
Please fill out all questions and deposit payment per child, plus (Active Kids voucher), into this account: CDSFA BSB: 032 082 ACCT: 113 442 please add your child's name on the deposit.
Child's Name
First Name
Last Name
Age
-
Month
-
Day
Year
Date
Parent/Contact
First Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Program Location
Roselands Wednesdays Feb-March 23
HPW Saturdays Saturday April 23
Roselands Saturday April-June 23
Active Kids Voucher #
Any Alergies, if so please list.
Club enrolled season 2022
Submit
Should be Empty: