JULY school HOLIDAY PROGRAM REGISTRATION FORM Parents/Carers Name First Name Last Name Parent/Carer Phone (###) ### #### Parent/Carer Email Address Address 1 Address 2 City State/Province Zip/Postal Code Country Child/Young Persons Details * First Name Last Name Child/Young Person Email Age Child/Young Persons Age Any medical requirements of Child/young personSubject * 08/07/25 - Drop In @ Youth Hub (ages 10-18) 10/07/25 - AT MAXIMUM CAPACITY 15/07/25 - Indoor Rock Climbing (ages 8-18) 17/07/25 - Bowling (ages 4-18) Thank you! AT MAXIMUM CAPACITY10/07/25 - All 4 Kids Play Centre (ages 4-12)