Form

Join us these April school holidays learning about the moana!

First name*

Last name*

Email*

Phone number*

Emergency contact name*

DIFFERENT to main contact!
Please add their relationship to the child

Emergency contact number*

Date Selection!*

15th April 2025 Kelly Tarltons

Name of child*

Age of child*

Gender of child 1

Name of second child

Age of child 2

Gender of child 2

Name of third child

Age of child 3

Gender of child 3

Are there any allergies that we need to be aware of (please specify any instructions and or management requirements for these - eg epipen or medication)?*

Please specify if any medication needs to be taken on the day.

Is there anything else that we should know about your child/ children so that we can make their experience as positive as possible?*

Permission for photography*

I give permission

I do not give permission

Yes, but please check before publishing

Important information:
Your child's place won't be confirmed until payment is received.