Class Enrolment / Details Form

Child's Details

First Name

Last name

Child's Birthday

Day

Month

Year

Best Contact Phone Number

Best Contact Email

Please provide the best emergency contact for your child. If it is the same contact details, please provide the contacts full name. If it someone different, please provide full name and best contact phone number.

Address

Multi-line address

Country/Region

Address

City

Zip / Postal code

If you ticked any of the above, and feel comfortable doing so, please provide any details you feel are relevant for us to know to help facilitate the best class/learning experience for your child.

Please tick this if you intend on/would like to send through an action plan for any of the conditions you have provided information for. For example an asthma plan. Please email this to enquiries@sabasecamp.com.au

Is there anything else you feel we should know?

Signature

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Date

Day

Month

Year

By ticking this box you are agree that you as the parent/guardian are responsible for any outstanding fees.

By ticking this, you agree that all the information you have supplied is correct and true at the time of submission.