Thrive in Sport School Holiday Program - Registration Form
April 2024
Parent/Guardian Details
Name
First Name
Last Name
Email
example@example.com
Phone Number
-
Area Code
Phone Number
Participant Details
Dates attending Holiday Camp
Please tick the dates you wish your child to attend the holiday camp
Whole Week Options
Whole Week - 15th - 19th April (9am-3pm) $240
Whole Week - 22nd - 26th April (9am-3pm) $240
One Day Options
15th April - (9am - 3pm) $55
16th April - (9am - 3pm) $55
17th April - (9am - 3pm) $55
18th April - (9am - 3pm) $55
19th April - (9am - 3pm) $55
22nd April - (9am - 3pm) $55
23rd April - (9am - 3pm) $55
24th April - (9am - 3pm) $55
25th April - (9am - 3pm) $55
26th April - (9am - 3pm) $55
Total amount due: (please include the amount payable for the choices of dates you have made)
Registration confirmed on receipt of payment to account
01-0811-0859249-00 (Please include name of child and the reference SHPApril24)
Name of Child
First Name
Last Name
Date of Birth
-
Month
-
Day
Year
Date
Gender
Male
Female
Rather not say
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Emergency Contact Information
Name
First Name
Last Name
Phone Number
-
Area Code
Phone Number
Relationship to Child
Medical Details
Any known allergies or medical conditions
Medications currently being taken
Emergency action plan (if applicable)
Terms and Conditions
Consent for the use of participant's image and likeness for program-related promotional materials
Please Select
Yes
No
Please Read
Submit
Should be Empty: