Summer Camp 2024 Registration

Summer 2024 Performing Arts Day Camp Registration

(NOTE: This form can only completed by someone who is 18 years or above)

HUNTER/NEWCASTLE/CENTRAL COAST:
Wed 24 January 2024 - Thurs 25 January 2024
Venue: Fletcher Community Centre (55 Kurraka Dr, Fletcher NSW 2287)
**Drop off: 8am; Pick Up: 4pm, each day.**
*NOTE: Before & After Camp child minding available if needed, please reach out to us to arrange.*
**Camp Fee: $150 per child**
**Discounted Payment Options:**
1. Use the $50 NSW Creative Kids Voucher, LangDentity gives a $50 discount, therefore parents only pay $50
2. LangDentity gives $50 discount and a payment plan of $25 per fortnight until the remaining $100 is paid
In any of the options above, parents that are new to LangDentity get an additional $25 discount. Please reach out to us for promotional code.
**IMPORTANT NOTICE:** Before signing up, please read our **Risk Waiver**

Which camp location is your child attending?

Name of adult dropping off or picking up the child to camp

First Name

Last Name

Mobile Number

Name of First Child

First Name

Last Name

Gender of First Child

Age of First Child

Name of Second Child

First Name

Last Name

Gender of Second Child

Age of Second Child

Name of Third Child

First Name

Last Name

Gender of Third Child

Age of Third Child

Dietary Restrictions or Allergies

Please let us know any dietary restrictions or allergies for any of the attendees. Enter N/A if it does not apply.

Anaphylaxis plan

If applicable, please let us know the Anaphylaxis plan in case of emergency

Name of Emergency Contact

First Name

Last Name

Address of Emergency Contact

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Email of Emergency Contact

Mobile Phone of Emergency Contact

(###)

###

####

Confirmation of Understanding of Risks

By submitting this form and signing your name below you confirm that you have read the safety instructions/warnings here: www.langdentity.com.au/riskwaiver

Name of the Person Completing the Form

First Name

Last Name

Today's Date

MM

DD

YYYY

Summer 2024 Performing Arts Day Camp Registration

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