Cooroy Rego Form

Cooroy Rego Form

Kids Club 2025 Registration Form
Amount of Children to Register*
4 max. Submit second registration for more
Parent/Guardian Details

Used for contacting guardian if required. This information will not be used for marketing purposes
Parent/Guardian Name*

First NameLast Name
Contact Phone Number*
Email*
example@example.com
Relation to children

Child 1
Name*

First NameLast Name
List any allergies child has
List any medications child takes during Kids Club hours
Hours: 9:00am - 12midday
I grant permission for my child to be photographed or videos and the images to be be posted on the Cooroy Gospel Hall web page*

Child 2
Name*

First NameLast Name
List any allergies child has
List any medications child takes during Kids Club hours
Hours: 9:00am - 12midday
I grant permission for my child to be photographed or videos and the images to be be posted on the Cooroy Gospel Hall web page*

Child 3
Name*

First NameLast Name
List any allergies child has
List any medications child takes during Kids Club hours
Hours: 9:00am - 12midday
I grant permission for my child to be photographed or videos and the images to be be posted on the Cooroy Gospel Hall web page*

Child 4
Name*

First NameLast Name
List any allergies child has
List any medications child takes during Kids Club hours
Hours: 9:00am - 12midday
I grant permission for my child to be photographed or videos and the images to be be posted on the Cooroy Gospel Hall web page*

Confirm Details
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Should be Empty: