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Online forms: Kingsway Indoor Stadium School Holiday Program Registration

Participant Details

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Full name of participant Required

Date of Birth Required

Address Required

Participant Age

Does the participant suffer from any medical conditions / allergies / injuries? Required Yes No

Please list as much detail as possible relating to the above health and medical information to assist with the appropriate care needed to support the participant

What school does your child attend?

Parent/Guardian Full Name Required

Address (if different to participant)

Phone Number (please enter a valid telephone number in one of the following formats e.g. 08 9405 5000 or 0400 000 000. Please make sure that you include the area code for a landline number and use the correct spacing between the numbers.) Required

Email Address (please ensure there is no space at the end of your email address) Required

Name Required

Relationship to Participant Required

Phone Number (please enter a valid telephone number in one of the following formats e.g. 08 9405 5000 or 0400 000 000. Please make sure that you include the area code for a landline number and use the correct spacing between the numbers.) Required

Name Required

Relationship to Participant Required

Phone Number (please enter a valid telephone number in one of the following formats e.g. 08 9405 5000 or 0400 000 000. Please make sure that you include the area code for a landline number and use the correct spacing between the numbers.) Required

Do you consent to videos or photos to be taken for marketing purposes? Yes No