July 2026 EOI School Holiday Program

July 2026 School Holiday Activities Expression of Interest

Parent/Carer Permission Form
The information we collect is required to manage risk, provide reasonable care and administer your child's involvement in the program. Information is kept confidential and only provided to those involved in the activities. (eg. First Aid, Coaches, Instructors and Communities for Children).
Please choose your first preference:
Please choose your second preference:
Please choose your fourth preference:
1. Child/Teens Name

First NameSurname
Age
Date of Birth

DayMonthYear
Date of
Gender
Parent/Guardian Name
Mobile No.
Format: 0000000000.
Email
example@example.com
Address
Do you identify as Aboriginal and/or Torres Strait Islander?
EMERGENCY CONTACT/AUTHORISED PERSON:
Name
Relationship to Child
Emergency Mobile No
Format: 0000000000.
MEDICAL INFORMATION
Will you child/children need to take any medication during the program/s?
If medication is required, please specify
Please list any medical/physical conditions below.
Please list any allergies/food intolerance etc.
Please list any relevant behavioral issues we should be aware of.
I permit photographs to be taken and used for Kids & Teens in the Valley. No names will be used on social media/newsletters.
Would you like to know about other Kids & Teens in the Valley programs and activities happening throughout the year?
CONSENT
Name/Signature
Date

DayMonthYear
Date
Any Further Comments
If you have any questions, please email us on bookings@kidsinthevalley.com.au
Should be Empty:

July 2026 School Holiday Activities Expression of Interest

EMERGENCY CONTACT/AUTHORISED PERSON: