Kidz Klub Registration Form

Please complete the form below for EACH child you wish to register at Kidz Klub this will save time doing it on the door when dropping them off!
Your Name
Relationship to child
Address line 1
Address line 2
Address line 3
Address line 4
Postcode
E-mail
Home Telephone Number
Emergency Telephone Number
Please fill the following sections for EACH child you wish to register

CHILD 1:
Child 1 Name
Child 1: Gender



Child 1: Date of Birth (DD/MM/YYYY)
Allegies or Information
CHILD 2
Child 2: Name
Child 2 Gender



Child 2: Date of Birth
Child 2: Allegies or Information

CHILD 3:
Child 3: Name
Child 3: Gender



Child 3: Date of Birth
Child 3: Allergies or Information

CHILD 4:
Child 4: Name
Child 4: Gender



Child 4: Date of Birth
Child 4: Allergies or Information
I have read and understand the details of Kidz Klub. I hereby give my consent for my child/ren to attend the Klub as detailed. I also give consent for the workers to administer any First Aid that may be necessary, to my child/ren in the event of an accident/injury. I also give consent for my child/ren to receive any necessary hospital or dental treatment including anaesthetic.
Photographs taken during Kidz Klub, including children attending, are occasionally used as part of our publicity and used on our web site. Unless advised otherwise we use this form as your consent for this.
Consent Approval



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