Floating Classroom Afterschool Nature Club (Stone Wharf) Registration Form

Afterschool Nature Club (Stone Wharf) Registration Form
Child's Full Legal Name

First NameLast Name
Child's Preferred Name (if different)
Child's Date of Birth

DayMonthYear
Date
Name of child's school
School's Postcode
Type of school
Parent / Guardian / Carer's Name

First NameLast Name
Email Address
example@example.com
Phone Number
Child's Home Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Please provide a name and phone number for an additional emergency contact (in case we can't reach you)
Does your child have any access or learning needs?
If yes, please provide details so that we can ensure that we are able to provide appropriate support.
Does your child have any dietary requirements or allergies?
Is the child a refugee or asylum seeker?
Photo Consent
How did you hear about this club?
Would you like to receive information about future holiday and afterschool clubs at the Floating Classroom by email?
Should be Empty: