Hurstville Aquatic Centre Holiday Program
Hurstville Aquatic Centre Holiday Program
Kids Holiday Program Enrolment Form
Child 1 Name:
*
Date of Birth:
*
School Attending:
*
Child 2 Name:
Date of Birth:
School Attending:
Address
*
Suburb:
*
Postcode:
*
Parent/Guardian's Name:
*
Work Number
*
Home Number
*
Mobile Number
*
Email:
*
Emergency information Name:
*
Relationship
*
Work Number
*
Home Number:
*
Mobile Number
*
Medical Conditions: (Allergies, Asthma, epilepsy, disabilities, heart conditions etc.)
Medications:
Child can swim 25m:
*
Yes
No
Choose a week (or both):
Week 1 - Monday 27th Sept - Friday 1st Oct $190
Week 2 - Monday 4th Oct - Friday 8th $190
Or choose the days:
Mon 27th$38/child
After Care $10/child
Tue 28th $38/child
After Care $10/child
Wed 29th $38/child
After Care $10/child
Thur 30th $38/child
After Care $10/child
Fri 1st $38/child
After Care $10/child
Mon 4th $38/child
After Care $10/child
Tue 5th $38/child
After Care $10/child
Wed 6th $38/child
After Care $10/child
Thur 7th $38/child
After Care $10/child
Fri 8th $38/child
After Care $10/child
