School Holiday Program Booking Form – Waikato Football Academy

Child's Full Name *

First

Last

Child's Date of Birth *

Gender *

Address *

Email *

Daytime Contact Number *

Emergency Contact Number *

Parent/Guardian Name *

First

Last

Medical Conditions *

Days Attending *

Please ensure you select the correct days that you are attending

Photographs may be taken of the children and staff to be used as promotional material only. Please indicate below if you consent or not for your child to be included.

Yes I do consent to photos/videos being taken of my child during the programme
No I do not consent to photos/videos being taken of my child during the programme