St Leonards Final Booking

Your Details

Only you as the registered BubbaDesk Member may attend the coworking space. For another parent or caregiver to rotate attending, please email lauren@bubbadesk.com.
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Post Code
E-mail*
Mobile*
Occupation*
Employer*
Business Name (if required for invoicing purposes)
BubbaDesk Start Date*

DayMonthYear
Date
Number of Days per Week*

1 Day Per Week2 Days Per Week3 Days Per Week4 Days Per Week5 Days Per Week
Preferred Days - please tick all options that suit, and we will do our best to accommodate.*

MondayTuesdayWednesdayThursdayFriday
Child Details

For attending children only.
Child 1 Name*

First NameLast Name
Child 1 DOB*

DayMonthYear
Date
Child 2 Name

First NameLast Name
Child 2 DOB

DayMonthYear
Date
Immunisation up to date? Children must be up to date to attend.*

YesNo
If your child(ren) has any allergies, please note.
Does your child have any additional needs?
You are welcome to share your membership with a partner, for no additional charge. You can alternate days, or you can both come together.
Will you be sharing this Membership with a partner? (No additional charge)*

NoYes
Partner Name*

First NameLast Name
Partner Email*
example@example.com
Emergency Contact
Name*

First NameLast Name
Mobile*
Terms & Conditions

Please ensure you read and agree fully to our terms.
As a part of the BubbaDesk membership sign-up process, a small administrative fee/booking charge is applied to ensure that members are committed to utilising our services. In the event of a cancellation with a 30-day notice, a 100% refund can be issued.
Membership Admin Fee*
prevnext( X )
Admin Fee$100.00AUD
To secure your spot, a once-off, non-refundable Administration fee is required.

Subtotal $0.00AUDTax $0.00AUDTotal $0.00AUD
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Your Details

Child Details

Emergency Contact

Terms & Conditions