April Holidays Kids Club Registration
Come and join the fun these holidays - FREE - Wednesday to Friday (April 24 - 26), 9:30am - 12:00pm. Ages 7-12yrs. Register today.
Child/ren Details
Child 1
Child's Name
*
First Name
Last Name
Child's Birth Date
*
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Year
Male or Female
Male
Female
Child's Allergies or medical problems, 1:
Enter 'Nil' if none
Child's Allergies or medical problems, 2:
Enter 'Nil' if none
Child 2
Child's Name
First Name
Last Name
Child's Birth Date
Please select a day
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31
Day
Please select a month
January
February
March
April
May
June
July
August
September
October
November
December
Month
Please select a year
2024
2023
2022
2021
2020
2019
2018
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1928
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1925
1924
1923
1922
1921
1920
Year
Male or Female
Male
Female
Child's Allergies or medical problems, 1:
Enter 'Nil' if none
Child's Allergies or medical problems, 2:
Enter 'Nil' if none
Child 3
Child's Name
First Name
Last Name
Child's Birth Date
Please select a day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
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27
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29
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31
Day
Please select a month
January
February
March
April
May
June
July
August
September
October
November
December
Month
Please select a year
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
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1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
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1969
1968
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1952
1951
1950
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1948
1947
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1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
Year
Male or Female
Male
Female
Child's Allergies or medical problems, 1:
Enter 'Nil' if none
Child's Allergies or medical problems, 2:
Enter 'Nil' if none
Child 4
Child's Name
First Name
Last Name
Child's Birth Date
Please select a day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Day
Please select a month
January
February
March
April
May
June
July
August
September
October
November
December
Month
Please select a year
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
Year
Male or Female
Male
Female
Child's Allergies or medical problems, 1:
Enter 'Nil' if none
Child's Allergies or medical problems, 2:
Enter 'Nil' if none
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Next
Parent/Guardian Details
Parent/Guardian Name
*
First Name
Last Name
Address
*
Street Number and name
Street Address Line 2
Town
State / Province
Postal / Zip Code
E-mail Address
example@example.com
Contact Number
*
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Next
Emergency Contact Details
Emergency Contact Name
*
First Name
Last Name
Relationship
*
Contact Number
*
Please enter a valid phone number.
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Next
Permission to Participate Terms and Conditions
1. Transportation
Adult volunteers and chaperones may be available to transport the participants on any excursions that require motor vehicle transportation. Adults will all hold a valid Full License. First aide will be available amoung our volunteer(s).
2. Requirements
The child named above is in good health and has no physical or medical limitations that would cause the activities as described above to be detrimental or dangerous to the child. Parents/guardians should specify allergies and medical problems in section above.
3. Consent
I give permission as the parent\guardian(s) of the above-named child(ren) and consent to the child(ren) to participate in the activities provided by Kids Club. I understand there may be some minimal level of risk resulting from some of the activities which may result in physical injury to my child (e.g. grazed knee from sports), but nonetheless specifically request that he or she be allowed to participate in those activities.
4. Emergencies
If the above-named child(ren) requires first aide treatment, I consent to and authorize the activity volunteer(s) to apply the treatment. Furthermore, if more serious treatment is required I consent to and authorize the volunteer(s) to get my child to the appropriate medical professionals for their assessment and necessary procedures or treatments.
5. Emergency Contacts
If, in the event of a medical or other emergency, I am unable to be reached by telephone at the numbers listed below, I authorize the activity volunteer(s) to attempt to contact me through the emergency contacts listed on this registration form.
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Sign Off
I, the parent/guardian, confirm that I have carefully read the Permission to Participate Terms and Conditions, understand it contents, and agree to its terms and conditions.
*
Yes
No
Photos and video footage can be taken of my child(ren) interacting in Kids Club activities.
*
Yes
No
Signature
Type in your first and last name if completing online. By typing you name you are agreeing to the Terms and Conditions on this registration form.
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