Little Explorers Club Sign Up
Please complete this form to join us!
Child's Name
*
First Name
Last Name
Date of birth
*
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Day
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Month
Year
2 digit day, 2 digit month, 4 digit year
Date
Gender
*
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Female
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Add second child?
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Second child's name
First Name
Last Name
Second child's date of birth
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Day
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Month
Year
2 digit day, 2 digit month, 4 digit year
Date
Second child's gender
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Female
Prefer not to say
Add third child?
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Yes
No
Third child's name
First Name
Last Name
Third child's date of birth
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Day
/
Month
Year
2 digit day, 2 digit month, 4 digit year
Date
Third child's gender
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Male
Female
Prefer not to say
Parent/Guardian Name
*
First Name
Last Name
Home Phone
Please enter a valid phone number.
Format: (00000) 000000.
Mobile
*
Please enter a valid phone number.
Format: 00000000000.
Email
*
example@example.com
I give permission for my child to appear in Churcher’s College marketing photographs/video.
*
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No
I give permission to be added to the mailing list for future Churcher’s events.
*
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No
Churcher's College asks you to provide personal data on this form which is stored by Churcher's College regarding the Little Explorers activity. You are required to give your consent that this data can be processed by Churcher's College.
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