Holiday Program Enrollment Form - Top End Multi Sports

Details

Child’s Name*

Date of Birth*

Address*

Person to be contacted*

Emergency Contact No.*

Email Address*

Booking Contact Name

I, the above mentioned name, give consent for my child to participate in the TEMS Holiday Programas programmed and conducted by Hollie Goodall and any other employees/contractors ofTEMS.
I authorize Hollie Goodall and any assistant trainers of TEMS to obtain any medical assistance, which they may deem necessary should an accident occur, and agree to pay all medical expenses incurred.
I submit the attached medical information about my child and include other relevant information and details of limitations.
I further authorize qualified practitioners to administer anesthetic if such an eventuality arises.
I agree to a cancellation fee of $35 if less than 6hours’ notice is given and 100% of fee if less than 2 hours’ notice is given.
I agree that payment will be made in full prior to my child beginning the above mentioned program.

Medical Condition*

Further Information*

Other Medical Information*

Location of Holiday Program – 110 Old McMillans Rd, Coconut Grove Cost $50 per day or $225 per week

Book In Days*

Program Type*

Approximate Drop Off Time*

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Approximate Pick Up Time*

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Read Terms of Site*

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