Spike Prime Term 4 2023 - St John's Anglican Church Jville (Return)

Spike Prime

St John's Anglican Church Johnsonville

18 Bassett Road, Johnsonville

Term 4 2023

28th October - 9th December 2023

Saturday 3:15 - 4:45pm

Child's Details

Student's Full Name:*

First NameLast Name

Parent / Caregiver Phone Number*

Format: (000) 000-0000.

Parent / Caregiver Email Address*

example@example.com

Second Emergency Contact Person Name *

First NameLast Name

Second Emergency Contact Person Phone :

Please enter a valid phone number.Format: (000) 000-0000.

Whole Term Booking*

Spike Prime Junior - Saturday 3:15-4:45pm ( 90 minutes ) - Whole Term - 7 Weeks

Saturday 21st October - 9th December 2023

$315.00NZD

Total

$0.00NZD

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Special Instructions

I agree not to send my child to a Bricks 4 Kidz Holiday Programme if presenting with cold or influenza-like symptoms.

I agree to my child receiving minor medical treatment, as considered necessary by first-aid certified staff. Furthermore, I agree to staff seeking further medical attention in the event of an emergency and I consent to treatment by medical authorities present.

YesNo