Student Details

First Name

Last Name

Parent/Guardian's names

Contact Details

Address

Suburb

Postcode

Phone Number

Mobile Number

Email address

Emergency Contact Name

Emergency Contact Number

Other Details

Allergies (including foods) / Illness / Disorders

Current medication (if any)

Days Attending

---Monday Only - $60Tuesday Only - $60Both Days - $90

In the case of an emergency, do you give permission for our teachers to call 000, and perform first aid on this student if the situation requires it, and agree to incur the costs of that service?
 Yes No