Holiday Camp Waiting List

Parent/Guardian Details

Child Details

Female
Male
Non-Binary

DOB   - 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 ---- January February March April May June July August September October November December ---- 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022

Choose school year in 2025... Preschool Kindy/Prep Year 1 Year 2 Year 3 Year 4 Year 5 Year 6 Year 7 Year 8 Year 9 Year 10 Year 11 Year 12

Medical Details

Does the student have a diagnosed medical or other condition (eg. ADHD, autism) that we should be aware of?
No Yes

Student carries medication(s)

Student has one or more allergies

I agree to staff administering first aid/emergency treatment if necessary

Add another child