After School Art Class Booking

Child 1:
Name:
(required)
Age:
(required)
School:

Child 2:
Name:

Age:

School:

Please select which day requested:

Payment must be received before this booking is confirmed
Payment Method:
Direct Deposit (Name: Hodco, bsb: 062 184, Acc: 11377111) please use your child's name as referenceCredit Card (please call 02 9130 4855 with your credit card details)

Name of Parent/Guardian:
(required)
Mobile:
(required)
Email:
(required)
Home Address:
(required)
Other Emergency Contact:
Name:
(required)
Mobile:
(required)
Authorised to collect child in addition to Parent/Guardian name above:
Name 1:

Relationship:

Additional Information:
Any allergies or Medical conditions or other details we should know about:

I give permission for my child/ren to be photographed during the camp. I understand that pictures may be used in our Facebook page in the future:
YESNO