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1. Parent / carer full name: (Required.)

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2. Parent / carer phone number: (Required.)

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3. List your child/ren's full name/s:
You are able to list up to two children below.
(Required.)

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4. What school does your child/ren currently attend? (Required.)

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5. Which workshop would you like your child/ren to attend?

Years 3 and 4 – Wed 8th October (suitable for 8 – 11 years*)

Years 5 and 6 – Thurs 9th October (suitable for 10 – 13 years*)
*discussion about the most suitable classes can be arranged if required.
(Required.)

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6. Will your child bring a friend along? (Required.)

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7. Do you wish for your child/ren to participate in the lunchtime excurision
activity [either Flip Out or Strike (for either bowling, laser tag or mini golf)] at Charlestown Square. An extra $12 per child will be charged for activity participation.
(Required.)

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8. List any medical conditions and diagnoses we need to be aware of:

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9. Specify dietary or medical requirements, or do you have any further comments or questions?

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