First Name
*
Last Name
*
Address
*
Street Address
City
State
Postal Code
Phone
*
Email
*
Childs Full Name
*
Childs Date of Birth
*
2nd Child's Full Name
2nd Child's Date of Birth
3rd Child's Full Name
3rd Child's Date of Birth
Has your child (ren) got any medical/additional needs?
*
HAF Week 4 Day/s Required
*
Monday 10th August
Tuesday 11th August
Wednesday 12th August
Thursday 13th August
I will provide my child with suitable footwear, clothing and hydration throughout the course of the day.
*
Yes
No
I give permission for KSA to administer first aid to my child?
*
Yes
No
I give consent for my child's photo/video to be taken and used for marketing use.
*
Yes
No
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