AC Kidz Club Registration Form

WHO: Year 3-6
FOOD: Afternoon Tea provided
WHERE: ACBC Primary School – Inlet Boulevard, Mogum Bend, South Yunderup
COST: $35 per term, per child. $5 weekly per child. (registered in advance, no payment taken on the day).
WHEN: Term 4 starts October 15th

Austin Cove ACE Kids (After School Care) are free but must register through ACE to attend AC Kidz Club. Please see Yudeesha to get your child registered.

Term 4 Registration

Parent / Guardian Name

Email Address

Contact Number

Has your child/ren previously been registered for AC Kidz Club?

Child 1 Name

Child 1 Date of Birth

Gender

School Grade

Medical Information

Do you have more children to register?

Child 2 Name

Child 2 Date of Birth

Gender

School Grade

Medical Information

Do you have more children to register?

Child 3 Name

Child 3 Date of Birth

Gender

School Grade

Medical Information

Do you have more children to register?

Child 4 Name

Child 4 Date of Birth

Gender

School Grade

Medical Information

Please include all names of people permitted to collect your child here (except your own).