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Select your state... New South Wales Victoria

Select your location... Artarmon Girl Guides Hall Artarmon Scout Hall Boronia Park Uniting Church Castle Cove Public School Hall Denistone East Public School Hall Gordon West Public School Hall Jasper Road Public School Hall Kent Road - YMCA (Meeting Room) Mosman Art Gallery (Grand Hall) - Tuesday Mosman Art Gallery (Grand Hall) - Wednesday Neutral Bay PS (Music Room) - Friday Neutral Bay PS (Music Room) - Monday Neutral Bay Uniting Church (Newlands Room) Petersham Public School Hall Pymble Public School Hall Roseville Public School Hall Strathfield North Public School Hall Victoria Avenue Public School Willoughby Scout Hall

Select your class... Mosman Seniors TUE (Y6 to Y9) Term 1 2021

Next free trial date for this class is 9 March 2021

Parent/Guardian Details

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Australian Capital Territory New South Wales Northern Territory Queensland South Australia Tasmania Victoria Western Australia

Emergency Contact

Student Details

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Female

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 ---- 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021

Year at school in 2021 Choose... 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 Year 13

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

Consent

I agree to the Terms & Conditions for Holiday Camps and/or Drama Classes as applicable to any future enrolments

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